Community hospital ethics consultation: evaluation and comparison with a university hospital service

• Published in: The American journal of medicine Vol. 92; no. 4; p. 346
• Main Authors: La Puma, J, Stocking, C B, Darling, C M, Siegler, M
• Format: Journal Article
• Language: English
• Published: United States 01-04-1992
• Subjects: Adolescent; Adult; Advance Directives; Aged; Aged, 80 and over; Attitude of Health Personnel; Bioethical Issues; Child; Child, Preschool; Ethicists; Ethics Consultation; Ethics, Clinical; Ethics, Medical; Evaluation Studies as Topic; Female; Hospitals, Community - standards; Hospitals, University - standards; Humans; Internship and Residency; Interprofessional Relations; Interviews as Topic; Male; Medical Staff, Hospital; Mental Competency; Middle Aged; Physician-Patient Relations; Prospective Studies; Referral and Consultation; Empirical Approach; Professional Patient Relationship
• ISSN: 0002-9343
• DOI: 10.1016/0002-9343(92)90262-A

Ethics consultants may improve patient care by responding to physician requests for assistance with problems they identify as ethical issues.
To examine three aspects of ethics consultation: the clinical questions asked; the helpfulness of the consultation to requesting physicians; and the differences between consultations performed at a community teaching hospital and those performed at a university hospital.
A community teaching hospital and a university teaching hospital.
Physicians who formally requested ethics consultations in both hospitals and the patients for whom they requested them.
Over 2 years (January 1, 1988, to December 31, 1989), we prospectively evaluated a newly established clinical ethics consultation service in a community teaching hospital using confidentially completed, pretested, structured questionnaires, and compared our data with previously reported university hospital data.
During the 2-year study, 104 consultation requests were received from 68 physicians in eight departments. Requesters most often requested consultation about deciding to forego life-sustaining treatment (74%), resolving disagreements (46%), and assessing patient competence (30%). Requesters found the consultation "very helpful" or "helpful" in one or more aspects of patient care in 86% of cases, or in one or more aspects of physician education in 86% of cases. These data are similar to university hospital data.