Medicine, Health Care and Philosophy

, Volume 11, Issue 1, pp 27–34 | Cite as

Does fear of retaliation deter requests for ethics consultation?

  • Marion Danis
  • Adrienne Farrar
  • Christine Grady
  • Carol Taylor
  • Patricia O’Donnell
  • Karen Soeken
  • Connie Ulrich
Scientific Contribution

Abstract

Background

Reports suggest that some health care personnel fear retaliation from seeking ethics consultation. We therefore examined the prevalence and determinants of fear of retaliation and determined whether this fear is associated with diminished likelihood of consulting an ethics committee.

Methods

We surveyed registered nurses (RNs) and social workers (SWs) in four US states to identify ethical problems they encounter. We developed a retaliation index (1–7 point range) with higher scores indicating a higher perceived likelihood of retaliation. Linear regression analysis was performed to identify socio-demographic and job characteristics associated with fear of retaliation. Logistic regression analysis was performed to determine whether fear of retaliation was associated with less likelihood of seeking consultation. Results Our sample (N = 1215) was primarily female (85%) and Caucasian (83%) with a mean age of 46 years and 17 years of practice. Among the sample, 293 (48.7%) RNs and 309 (51.3%) SWs reported access to an ethics consultation service. Amongst those with access, 2.8% (n = 17) personally experienced retaliation, 9.1% (n = 55) observed colleagues experience retaliation, 30.2% (n = 182) reported no experience with retaliation but considered it a realistic fear, and 50.8% (n = 305) did not perceive retaliation to be a problem. In logistic regression modeling, fear of retaliation was not associated with the likelihood (OR = 0.64; 95% CI = 0.22–1.89) or frequency of requesting ethics consultation (OR = 0.81; 95% CI = 0.27–2.38). Conclusion Fear of retaliation from seeking ethics consultation is common among nurses and social workers, nonetheless this fear is not associated with reduced requests for ethics consultation.

Keywords

clinical ethics ethics consultation nurses organizational ethics retaliation social workers 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Ahern K., S. McDonald: 2002, The Beliefs of Nurses who were Involved in a Whistleblowing Event. Journal of Advanced Nursing 38, 303–209.PubMedCrossRefGoogle Scholar
  2. DuVal G., L. Sartorius, B. Clarridge, G. Gensler, M. Danis: 2001, What Triggers Requests for Ethics Consults? Journal of Medical Ethics 27(Supplement 1), 24–29.CrossRefGoogle Scholar
  3. Fontaine, N. and E. Allard: 1997, Advocacy in the Mental Health Services Field. Epidemiologia e psichiatria sociale 6, 29–39.PubMedGoogle Scholar
  4. Fouts S.F.: 2000, Two Nurses and a Doctor: Health Care Workers Allege Retaliation for Blowing the Whistle on Understaffing. Journal of Emergency Nursing 26(6), 598–600.CrossRefGoogle Scholar
  5. Keenan J.P.: 1995, Whistleblowing and the First-level Manager: Determinants of Feeling Obliged to Blow the Whistle. Journal of Social Behavior and Personality 10, 571–584.Google Scholar
  6. Masser B., R. Brown: 1996, When Would you do it? An Investigation into the Effects of Retaliation, Seriousness of Malpractice, and Occupation on Willingness to Blow the Whistle. Journal of Community & Applied Social Psychology 6, 127–130.CrossRefGoogle Scholar
  7. McDonald S., K. Ahern : 2000, The Professional Consequences of Whistleblowing by Nurses. Journal of Professional Nursing 16, 313–321.PubMedCrossRefGoogle Scholar
  8. Olson L.L.: 1998, Hospital Nurses’ Perceptions of the Ethical Climate of their Work Setting. Image – The Journal of Nursing Scholarship 30(4), 345–349.PubMedCrossRefGoogle Scholar
  9. Raines M.L.: 2000, Ethical Decision Making in Nursing: Relationship Among Moral Reasoning, Coping Style, and Ethics Stress. Journal of Nursing Administration’s Healthcare Law, Ethics, and Regulation 2, 29–41.CrossRefGoogle Scholar
  10. Silva M.C., J.M. Sorrell, J.J. Fletcher: 1999, The Personal Costs of Blowing the Whistle. NursingConnections 12, 14–17.PubMedGoogle Scholar
  11. Urban Walker, M.: 1993, Keeping Moral Space Open: New Images of Ethics Consulting. Hastings Center Report 2, 33–40.Google Scholar
  12. Williams E.S., T.R. Konrad, M. Linzer, J. McMurray, D.E. Pathman, M. Gerrity, M.D. Schwartz, W.E. Scheckler, J. Van Kirk, E. Rhodes, and J. Douglas for the SGIM Career Satisfaction Study Group, Society of General Internal Medicine:1999, ‹Refining the measurement of physician job satisfaction: results from the Physician Worklife Survey’, Medical Care 37(11), 1140–1154.Google Scholar

Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  • Marion Danis
    • 1
  • Adrienne Farrar
    • 1
  • Christine Grady
    • 1
  • Carol Taylor
    • 2
  • Patricia O’Donnell
    • 3
  • Karen Soeken
    • 4
  • Connie Ulrich
    • 5
  1. 1.Department of Clinical BioethicsNational Institutes of HealthBethesdaUSA
  2. 2.Georgetown UniversityWashingtonUSA
  3. 3.Inova Health SystemFalls ChurchUSA
  4. 4.University of MarylandCollege ParkUSA
  5. 5.University of PennsylvaniaPhiladelphiaUSA

Personalised recommendations