Evaluation of Viewpoints of Health Care Professionals on the Role of Ethics Committees and Hospitals in the Resolution of Clinical Ethical Dilemmas Based on Practice Environment

Abstract

We sought to evaluate whether health care professionals' viewpoints differed on the role of ethics committees and hospitals in the resolution of clinical ethical dilemmas based on practice location. We conducted a survey study from December 21, 2013 to March 15, 2014 of health care professionals at six hospitals (one tertiary care academic medical center, three large community hospitals and two small community hospitals). The survey consisted of eight clinical ethics cases followed by statements on whether there was a role for the ethics committee or hospital in their resolution, what that role might be and case specific queries. Respondents used a 5-point Likert scale to express their degree of agreement with the premises posed. We used the ANOVA test to evaluate whether respondent views significantly varied based on practice location. 240 health care professionals (108-tertiary care center, 92-large community hospitals, 40-small community hospitals) completed the survey (response rate: 63.6 %). Only three individual queries of 32 showed any significant response variations across practice locations. Overall, viewpoints did not vary across practice locations within question categories on whether the ethics committee or hospital had a role in case resolution, what that role might be and case specific queries. In this multicenter survey study, the viewpoints of health care professionals on the role of ethics committees or hospitals in the resolution of clinical ethics cases varied little based on practice location.

Service Providers’ Decision to Use Ethics Committees and Consultation in Complex Services

“…This is in accordance with research showing that people prefer to have someone else decide for them when the decision is emotionally laden and portends negative outcomes (Botti, Orfali, and Iyengar 2009). While recent works apply a finer-grained approach to investigate ethics consultation (e.g., Marcus et al 2015, 2016), studies have failed to address organizational factors involved in service providers’ decision regarding whether and when to approach an EC.…”

“…Following Marcus et al (2016), we used a stratified sample of employees of a multihospital network with three hospitals in the northeast United States. We generated a list of 1,460 potential respondents, including service providers such as physicians, nurses, and administrators.…”

“…At the time of the study's conception, the research oversight process in this health care system was undergoing revision that resulted in the Institutional Review Board covering only six hospitals (one tertiary care hospital, two smaller community hospitals, and three of the four larger community hospitals). These six hospitals were included in this study with Institutional Review Board approval (for details, see Marcus et al [2016]). a Rated on a scale of 1 ¼ "never," 2 ¼ "once a year or less," 3 ¼ "a few times a year," 4 ¼ "a few times a month," 5 ¼ "once a week," and 6 ¼ "more than once a week."…”

The first nationwide study on facing and solving ethical dilemmas among healthcare professionals in Slovenia

“…In the United States, HECs have existed since the early 1970s [13]. Only later were HECs introduced in countries throughout Europe as well as globally [14][15][16][17][18][19][20][21][22][23]. In addition to HECs, other means of resolving ethical dilemmas developed, mostly in northern Europe, where HCPs receive professional training to become facilitators of moral case deliberations among co-workers with whom they work every day [24,25].…”