Criteria for Determining the Appropriate Method for an Ethics Consultation

Smith, Martin L.; Bisanz, Annette; Kempfer, Ana J.; Adams, Barbie; Candelari, Toya G.; Blackburn, Roxann

doi:10.1023/b:hecf.0000037121.15801.0c

Cited by 22 publications

(14 citation statements)

References 2 publications

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“…However, the diversity of resources available to physicians in facing ethical difficulties may actually be beneficial. First, we do not currently know which approach would be most valuable [8], or even if a single approach can be considered sufficiently robust to be generalized to all the different contexts of clinical care [21,41]. Moreover, diversity itself could be an asset to ethics support.…”

Section: Discussionmentioning

confidence: 99%

Physicians’ Access to Ethics Support Services in Four European Countries

et al. 2007

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Clinical ethics support services are developing in Europe. They will be most useful if they are designed to match the ethical concerns of clinicians. We conducted a cross-sectional mailed survey on random samples of general physicians in Norway, Switzerland, Italy, and the UK, to assess their access to different types of ethics support services, and to describe what makes them more likely to have used available ethics support. Respondents reported access to formal ethics support services such as clinical ethics committees (23%), consultation in individual cases (17.6%), and individual ethicists (8.8%), but also to other kinds of less formal ethics support (23.6%). Access to formal ethics support services was associated with work in urban hospitals. Informal ethics resources were more evenly distributed. Although most respondents (81%) reported that they would find help useful in facing ethical difficulties, they reported having used the available services infrequently (14%). Physicians with greater confidence in their knowledge of ethics (P=0.001), or who had had ethics courses in medical school (P=0.006), were more likely to have used available services. Access to help in facing ethical difficulties among general physicians in the surveyed countries is provided by a mix of official ethics support services and other resources. Developing ethics support services may benefit from integration of informal services. Development of ethics education in medical school curricula could lead to improved physicians sensitivity to ethical difficulties and greater use of ethics support services. Such support services may also need to be more proactive in making their help available.

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Section: Discussionmentioning

confidence: 99%

Physicians’ Access to Ethics Support Services in Four European Countries

et al. 2007

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“…The approach taken by clinical ethicists in providing consultation is to model interdisciplinary collaboration and effective communication with patients and their families, with the objective of enhancing ethical decision making. [28][29][30] In effect, clinical ethicists in cases such as the one involving Mrs H act as facilitators of communication and decision making about goals for care, while directing attention to the ethical considerations underlying such decisions. Generally, clinical ethicists can help clarify differences in the way ethical considerations such as sanctity or quality of life are valued on the basis of religious, personal, or cultural values.…”

Section: Clinical Ethicists As a Resourcementioning

confidence: 99%

Role of Clinical Ethicists in Making Decisions About Levels of Care in the Intensive Care Unit

Faith

Chidwick

2009

Critical Care Nurse

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“…Smith et al 13 also summarise the advantages and disadvantages of different methods of consultation and mention several advantages of small team or entire hospital ethics committees including diverse perspectives, more thorough/thoughtful discussion, and so on.…”

Section: Discussionmentioning

confidence: 99%

“…Some problems may be appropriate for team ethics consultations and others may be more suitable for individual ethicist consultations or committee ethics consultations. Smith et al identified multiple criteria for a team consultation and mentioned that the team consultation is properly used when there is significant conflict, complexity, confusion and ambiguity; when the more formal process is specifically requested; and when gray area situations not immediately and clearly judged exist 13. In the light of these criteria listed by Smith et al , it might be necessary for our project to apply consultation methods other than a small team consultation according to the characteristics of the case presented.…”

Section: Discussionmentioning

confidence: 99%

A report on small team clinical ethics consultation programmes in Japan: Table 1

et al. 2008

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Clinical ethics support, including ethics consultation, has become established in the field of medical practice throughout the world. This practice has been regarded as useful, most notably in the UK and the USA, in solving ethical problems encountered by both medical practitioners and those who receive medical treatment. In Japan, however, few services are available to respond to everyday clinical ethical issues, although a variety of difficult ethical problems arise daily in the medical field: termination of life support, euthanasia and questions about patient autonomy. In light of these conditions, a group of 17 volunteer educators and researchers from the area of biomedical ethics, including the authors, have formed the Clinical Ethics Support and Education Project, and began providing Japan's first small team clinical ethics consultation service in October, 2006. Members include scholars of biomedical ethics, scholars of philosophy and ethics, legal professionals and legal scholars, nurses and doctors, consisting of five women and 12 men. Consultation teams, made up of a small number of members, were organised each time a request for consultation was received. Over approximately 15 months (October 2006-December 2007), the programme received 22 consultation requests from medical practitioners and medical institutions, and three from the families of patients. In this paper, we will discuss the status of our consultation service and examples of consultation cases we have handled. In addition, we will examine the process of evaluating small team clinical ethics consultation services, as well as the strengths and weakness of such programmes.

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Criteria for Determining the Appropriate Method for an Ethics Consultation

Cited by 22 publications

References 2 publications

Physicians’ Access to Ethics Support Services in Four European Countries

Physicians’ Access to Ethics Support Services in Four European Countries

Role of Clinical Ethicists in Making Decisions About Levels of Care in the Intensive Care Unit

A report on small team clinical ethics consultation programmes in Japan: Table 1

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