Functions and Outcomes of a Clinical Medical Ethics Committee: A Review of 100 Consults
Jessica Richmond Moeller, Teresa H. Albanese, Kimberly Garchar, Julie M. Aultman, Steven Radwany & Dean Frate
HEC Forum 24 (2):99-114 (2012)
| Abstract | 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. Content Type Journal Article Pages 1-16 DOI 10.1007/s10730-011-9170-9 Authors Jessica Richmond Moeller, Department of Psychiatry and Behavioral Sciences, Akron General Medical Center, 400 Wabash Ave, Akron, OH 44307, USA Teresa H. Albanese, Health Services Research and Education Institute, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH 44304, USA Kimberly Garchar, Kent State University, 6000 Frank Ave., N.W, North Canton, OH 44720, USA Julie M. Aultman, Department of Family and Community Medicine, Northeast Ohio Medical University, P.O. Box 95, Rootstown, OH 44272, USA Steven Radwany, Palliative Care and Hospice Services, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH 44304, USA Dean Frate, Internal Medicine, Palliative Care and Hospice Services, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH 44304, USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737 | |||||||||
| Keywords | No keywords specified (fix it) | |||||||||
| Categories | ||||||||||
| Options |
|
|||||||||
Download options| PhilPapers Archive |
Upload a copy of this paper Check publisher's policy on self-archival Papers currently archived: 5,679 |
| External links |
 |
| Through your library | Configure |
Similar books and articlesColleen Gallagher & Ryan Holmes (2012). Handling Cases of 'Medical Futility'. HEC Forum 24 (2):91-98.
Jane Jankowski, Terese Seastrum, Robert Swidler & Wayne Shelton (2009). For Lack of a Better Plan: A Framework for Ethical, Legal, and Clinical Challenges in Complex Inpatient Discharge Planning. HEC Forum 21 (4):311-326.
Joy D. Skeel & Donnie J. Self (1989). An Analysis of Ethics Consultation in the Clinical Setting. Theoretical Medicine and Bioethics 10 (4).
Jeffrey P. Bishop, Joseph B. Fanning & Mark J. Bliton (2010). Echo Calling Narcissus: What Exceeds the Gaze of Clinical Ethics Consultation? HEC Forum 22 (1):171-171.
Michele K. Langowski & Ana S. Iltis (2011). Global Health Needs and the Short-Term Medical Volunteer: Ethical Considerations. HEC Forum 23 (2):71-78.
Erica K. Rangel (2009). Clinical Ethics and the Dynamics of Group Decision-Making: Applying the Psychological Data to Decisions Made by Ethics Committees. HEC Forum 21 (2):207-228.
Robert B. Shabanowitz & Judith E. Reardon (2009). Avian Flu Pandemic – Flight of the Healthcare Worker? HEC Forum 21 (4):365-385.
Lawrence J. Schneiderman (1995). When Families Request That 'Everything Possible' Be Done. Journal of Medicine and Philosophy 20 (2).
Tadeusz Tollocako (2000). Ethical Implications in the Allocation of Scarce Medical Resources in Poland. Science and Engineering Ethics 6 (1):63-70.
Ronald J. Cavanagh (1980). Mutuality in Medical Services. Theoretical Medicine and Bioethics 1 (2):207-211.
Tadeusz Tołłoczko (2000). Ethical Implications in the Allocation of Scarce Medical Resources in Poland. Science and Engineering Ethics 6 (1).
Robert M. Veatch (2009). Patient, Heal Thyself: How the New Medicine Puts the Patient in Charge. Oxford University Press.
Amy T. Campbell, Jay Sicklick, Paula Galowitz, Randye Retkin & Stewart B. Fleishman (2010). How Bioethics Can Enrich Medical-Legal Collaborations. Journal of Law, Medicine and Ethics 38 (4):847-862.
Frank H. Marsh (1992). Why Physicians Should Not Do Ethics Consults. Theoretical Medicine and Bioethics 13 (3).
Analytics
Monthly downloads |
Added to index2012-02-01Total downloads6 ( #145,615 of 549,087 )Recent downloads (6 months)1 ( #63,317 of 549,087 )How can I increase my downloads? |
My notes
Discussion
