Functions and Outcomes of a Clinical Medical Ethics Committee: A Review of 100 Consults
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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.
- Brennan, T. (1988). Ethics committees and decisions to limit care. Journal of the American Medical Association, 260, 803–807. CrossRef
- Csikai, E. (1998). The status of hospital ethics committees in Pennsylvania. Cambridge Quarterly of Healthcare Ethics, 7, 104–107. CrossRef
- Emanuel, E., & Emanuel, L. (1992). Four models of the physician-patient relationship. Journal of the American Medical Association, 267(16), 2221–2226. CrossRef
- Fox, E., Myers, S., & Pearlman, R. A. (2007). Ethics consultation in United States hospitals: A national survey. The American Journal of Bioethics, 7, 13–25. CrossRef
- Gonsoulin, T. P., & Taube, J. M. (2002). Hospital ethics committees: Formation, function, and case consultation. Journal of the Louisiana State Medical Society, 154, 323–327.
- LaPuma, J., Stocking, C. B., Silverstein, M. D., DiMartini, A., & Siegler, M. (1988). An ethics consultation service in a teaching hospital. Journal of the American Medical Association, 260, 808–811. CrossRef
- McGee, G., Spanogle, J., Caplan, A., Penny, D., & Asch, D. (2002). Successes and failures of hospital ethics committees: A national survey of ethics committee chairs. Cambridge Quarterly of Healthcare Ethics, 11, 87–93. CrossRef
- Radwany, S., Mason, H., Clarke, J. S., et al. (2009). Optimizing the success of a palliative care consult service: How to average over 110 consults per month. Journal of Pain and Symptom Management, 37, 873–883. CrossRef
- Romano, M. E., Wahlander, S. B., Lang, B. H., Li, G., & Prager, K. M. (2009). Mandatory ethics consultation policy. Mayo Clinic Proceedings, 84, 581–585.
- Rosner, F. (1985). Hospital medical ethics committees: A review of their development. Journal of the American Medical Association, 253, 2693–2697. CrossRef
- Scheirton, L. S. (1992). Determinants of hospital ethics committee success. H E C Forum, 4, 342–359. CrossRef
- Schneider, P. A. D. (2000). A study of twelve hospital ethics committees in Eastern South Carolina. Journal of the South Carolina Medical Association, 96, 409–415.
- Sexson, W. R., & Thigmen, J. (1996). Organization and function of a hospital ethics committee. Clinics in Perinatology, 23, 429–436.
- Van der Heide, I. G. (1994). Hospital ethics committees in practice: The case review function of four HECs in Connecticut. H E C Forum, 6, 73–84. CrossRef
- Youngner, S. J., Jackson, D. L., Coulton, C., Juknialis, B. W., & Smith, E. M. (1983). A national survey of hospital ethics committees. Critical Care Medicine, 11, 902–905. CrossRef
- Functions and Outcomes of a Clinical Medical Ethics Committee: A Review of 100 Consults
Volume 24, Issue 2 , pp 99-114
- Cover Date
- Print ISSN
- Online ISSN
- Springer Netherlands
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- Hospital ethics committee
- End-of-life decision making
- Palliative care
- Consult service
- Industry Sectors
- Author Affiliations
- 1. Department of Psychiatry and Behavioral Sciences, Akron General Medical Center, 400 Wabash Ave, Akron, OH, 44307, USA
- 2. Health Services Research and Education Institute, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH, 44304, USA
- 3. Kent State University, 6000 Frank Ave., N.W, North Canton, OH, 44720, USA
- 4. Department of Family and Community Medicine, Northeast Ohio Medical University, P.O. Box 95, Rootstown, OH, 44272, USA
- 5. Palliative Care and Hospice Services, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH, 44304, USA
- 6. Internal Medicine, Palliative Care and Hospice Services, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH, 44304, USA
- 7. University of Pittsburgh Medical Center, 200 Lothrop Street, Suite 933W, Pittsburgh, PA, 15213, USA