HEC Forum

, Volume 24, Issue 2, pp 99–114

Functions and Outcomes of a Clinical Medical Ethics Committee: A Review of 100 Consults

Authors

  • Jessica Richmond Moeller
    • Department of Psychiatry and Behavioral SciencesAkron General Medical Center
  • Teresa H. Albanese
    • Health Services Research and Education InstituteSumma Health System and Northeast Ohio Medical University
  • Kimberly Garchar
    • Kent State University
  • Julie M. Aultman
    • Department of Family and Community MedicineNortheast Ohio Medical University
    • Palliative Care and Hospice ServicesSumma Health System and Northeast Ohio Medical University
  • Dean Frate
    • Internal Medicine, Palliative Care and Hospice ServicesSumma Health System and Northeast Ohio Medical University
    • University of Pittsburgh Medical Center
Article

DOI: 10.1007/s10730-011-9170-9

Cite this article as:
Moeller, J.R., Albanese, T.H., Garchar, K. et al. HEC Forum (2012) 24: 99. doi:10.1007/s10730-011-9170-9

Abstract

Context: Established in 1997, Summa Health System’s Medical Ethics Committee (EC) serves as an educational, supportive, and consultative resource to patients/families and providers, and serves to analyze, clarify, and ameliorate dilemmas in clinical care. In 2009 the EC conducted its 100th consult. In 2002 a Palliative Care Consult Service (PCCS) was established to provide supportive services for patients/families facing advanced illness; enhance clinical decision-making during crisis; and improve pain/symptom management. How these services affect one another has thus far been unclear. Objectives: This study describes EC consults: types, reasons, recommendations and utilization, and investigates the impact the PCCS may have on EC consult requests or recommendations. Methods: Retrospective reviews of 100 EC records explored trends and changes in types of consults, reasons for consults, and EC recommendations and utilization. Results: There were 50 EC consults each in the 6 years pre- and post-PCCS. Differences found include: (1) a decrease in number of reasons for consult requests (133–62); (2) changes in top two reasons for EC consult requests from ‘Family opposed to withdrawing life-sustaining treatment (LST)’ and ‘Patient capacity in question’ to ‘Futility’ and ‘Physician opposed to providing LST’; (3) changes in top two recommendations given by the EC from ‘Emotional Support for Patient/Family’ and ‘Initiate DNR Order’ to ‘Comfort Care’ and ‘Withdraw Treatment.’ Overall, 88% of recommendations were followed. Conclusion: PCCS availability and growth throughout the hospital may have influenced EC consult requests. EC consults regarding family opposition to withdrawing LST and EC recommendations for patient/family support declined.

Keywords

Ethics Hospital ethics committee End-of-life decision making Palliative care Consult service

Copyright information

© Springer Science+Business Media B.V. 2012