The Slow, Steady Development of Pediatric Ethics Committees, 1975-2013

Myers, Daniel J.; Lantos, John D.

doi:10.1542/pir.35-3-e15

Cited by 4 publications

(4 citation statements)

References 14 publications

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“…Myers and Lantos noted inconsistency in their US-based study, and suggested that the lack of consistent standards for CES raises significant concerns about the integrity of ethics consultation. 20 We hold that heterogeneity in approach to consultation is not necessarily negative, as CES need to be responsive to local needs and appropriate to local culture. For example, the best consultation approach may differ in a community aged-care setting, compared with that best suited for an obstetric unit in a regional hospital.…”

Section: Discussionmentioning

confidence: 99%

“…The lack of consistent standards for CES has led some to question their integrity. 20 The development of consistent standards for CES operation would be a positive step to enhance their integrity. The authors agree with Godkin et al , that for clinical ethics to provide optimal integrated services, we need to gain knowledge of best practices and ways in which to measure effectiveness of the services.…”

Section: Introductionmentioning

confidence: 99%

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Paediatric clinical ethics in Australia and New Zealand: a survey

Cottle

Jansen

Irving³

et al. 2017

bmjpo

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ObjectivesTo quantify the presence, purpose, function, governance and funding of clinical ethics services (CES) in tertiary paediatric hospitals in Australia and New Zealand.Design, setting and participantsA descriptive, quantitative survey was conducted across eight paediatric hospitals.Main outcome measuresResponses from survey questions on the presence, purpose, function, governance and funding of the CES.ResultsSeven of eight tertiary paediatric hospitals identified access to CES. Regarding purpose and function, all CES provided clinical case consultation, six of seven provided education and training, six of seven assisted with organisational policy and guideline development and four of seven undertook original ethics research. There was wide variation in how case consultations were conducted, reported and documented. With respect to governance and funding, all CES reported to their hospital executive and only one CES reported having a dedicated, although small, budget.ConclusionsHeterogeneity in the process of case consultation and CES policy content exists across the organisations studied. There is consistency with the broader values that underpin CES such as their multidisciplinary nature and level of training required for key staff. There is an apparent lack of formal budgetary support from health services for CES activities, with support derived mostly from staff who contribute their time in addition to their primary roles.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Paediatric clinical ethics in Australia and New Zealand: a survey

Cottle

Jansen

Irving³

et al. 2017

bmjpo

View full text Add to dashboard Cite

show abstract

“…One retrospective survey, for example, found that the most frequent topic leading to a pediatric ethics consultation was end-of-life issues [12]. Surprisingly, despite the particular complexity of pediatric ethics cases, pediatric ethics committees have developed more slowly than adult ethics committees [13]. In some organizations, one consultation service handles cases pertaining to both adults and children.…”

Section: Distinguishing Adult From Pediatric Ethics Committeesmentioning

confidence: 99%

Health Care Ethics Consultation in the United States

2016

AMA Journal of Ethics

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“…Clinical ethics case consultation began emerging as a feature of paediatric healthcare in the mid-1970s 1 2. Since that time, the availability of clinical ethics support has become increasingly widespread and is now established in various forms in many paediatric hospitals in North America, Europe and elsewhere 3 4.…”

Section: Introductionmentioning

confidence: 99%

What kinds of cases do paediatricians refer to clinical ethics? Insights from 184 case referrals at an Australian paediatric hospital

McDougall

Notini

2016

J Med Ethics

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Clinical ethics has been developing in paediatric healthcare for several decades. However, information about how paediatricians use clinical ethics case consultation services is extremely limited. In this project, we analysed a large set of case records from the clinical ethics service of one paediatric hospital in Australia. We applied a paediatric-specific typology to the case referrals, based on the triadic doctor-patient-parent relationship. We reviewed the 184 cases referred to the service in the period 2005-2014, noting features including the type of case, the referring department(s) and the patient's age at referral. The two most common types of referral involved clinician uncertainty about the appropriate care pathway for the child (26% of total referrals) and situations where the child's parents disagreed with the doctors' recommendations for the child's care (22% of total referrals). Referrals came from 28 different departments. Cancer, cardiology/cardiac surgery and general medicine referred the highest numbers of cases. The most common patient age groups were children under 1, and 14-15 years old. For three controversial areas of paediatric healthcare, clinicians had initiated processes of routine review of cases by the clinical ethics service. These insights into the way in which one very active paediatric clinical ethics service is used further our understanding of the work of paediatric clinical ethics, particularly the kinds of ethically challenging cases that paediatricians view as appropriate to refer for clinical ethics support.

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The Slow, Steady Development of Pediatric Ethics Committees, 1975-2013

Cited by 4 publications

References 14 publications

Paediatric clinical ethics in Australia and New Zealand: a survey

Paediatric clinical ethics in Australia and New Zealand: a survey

Health Care Ethics Consultation in the United States

What kinds of cases do paediatricians refer to clinical ethics? Insights from 184 case referrals at an Australian paediatric hospital

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