Response to Open Peer Commentaries on “Ethics Consultation in U.S. Hospitals: A National Survey”

Fox, Ellen; Myers, Sarah; Pearlman, Robert A.

doi:10.1080/15265160701193575

Cited by 6 publications

(6 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…

AbstractEllen Fox and her colleagues (Fox, Myers and Pearlman 2007) have generated a rich set of data about ethics consultations in US hospitals that raise serious concerns about this mode of conflict resolution. Using the data they have collected, I want to highlight several issues that question the ethical legitimacy of the ethics consult service (ECS) model, and I want to argue that it may be time to replace ethics consultation with ethics mediation.

Comments

…”

mentioning

confidence: 99%

The Failure of the Consult Model: Why “Mediation” Should Replace “Consultation”

Fiester¹

2007

The American Journal of Bioethics

View full text Add to dashboard Cite

Ellen Fox and her colleagues (Fox, Myers and Pearlman 2007) have generated a rich set of data about ethics consultations in US hospitals that raise serious concerns about this mode of conflict resolution. Using the data they have collected, I want to highlight several issues that question the ethical legitimacy of the ethics consult service (ECS) model, and I want to argue that it may be time to replace ethics consultation with ethics mediation. Comments

show abstract

“…

Comments

…”

mentioning

confidence: 99%

The Failure of the Consult Model: Why “Mediation” Should Replace “Consultation”

Fiester¹

2007

The American Journal of Bioethics

View full text Add to dashboard Cite

show abstract

“…Previous efforts to measure aspects of ethics quality have included (1) studies evaluating ethics programs or elements of those programs (Fox et al 2007;Holloran et al 1995;Pearlman et al 2005); (2) tools to measure practices relating to a specific domain of health care or organizational ethics, such as patient-centered communication and patient privacy (Casarett et al 2008;Karro et al 2005;Wynia et al 2010); and (3) surveys of ethics-related culture in health care institutions (Ethics Resource Center 2000;Hofmann 2006;McDaniel 1997). Unlike the aforementioned strategies, the IESS represents an across-the-board approach to measuring ethics quality in a health care institution-addressing ethics program characteristics; multiple specific practice areas encompassing clinical, organizational, and research ethics; and ethics culture.…”

Section: Discussionmentioning

confidence: 99%

The IntegratedEthics^TMStaff Survey: A Tool to Evaluate and Improve Ethical Practices in Health Care

Pearlman

Bottrell

Altemose

et al. 2013

AJOB Primary Research

Self Cite

View full text Add to dashboard Cite

Background:To improve ethics quality in health care, health care organizations need a way to characterize whether ethical practices throughout the organization are consistent with accepted ethics standards, norms, and expectations for the organization and its staff. We developed the IntegratedEthics TM Staff Survey (IESS) to fill this need. Methods: The IESS was developed and validated through a rigorous multiyear process. This process included reviews of the bioethics and health care literature to develop conceptual maps of common ethical issues in health care; focus groups and interviews with institutional stakeholders to identify key ethical concerns; cognitive testing, pilot testing, and field testing to ensure that questions were understandable and useful; and item reduction and modification to reduce respondent burden. Results:The IESS addresses staff perceptions of ethical practices in nine domains: everyday workplace, business and management, government service, patient privacy and confidentiality, resource allocation, shared decision making with patients, professionalism in patient care, end-of-life care, and research. The 2010 version of the survey consisted of 76 questions (excluding 8 demographic questions), including questions about the degree to which facility staff demonstrate behavior consistent with specific ethical practices, systems-level or organizational factors that support or interfere with ethical practices, and the ethical environment and culture. The IESS has served as a catalyst for multiple quality improvement and educational activities. Conclusions: The IESS represents an across-the-board approach to measuring ethics quality in multiple areas encompassing clinical, organizational, and research ethics. In addition to its use in quality improvement efforts, the IESS may be used to assess whether there are systematic differences across different disciplines, services, and supervisory levels; to evaluate the effectiveness of ethics programs; and to identify trends in ethical practices over time.

show abstract

“…Participants were recruited from among researchers who have published several reports on ethics consultation, medical ethics, and bioethics in academic journals. Many of the individuals practicing ethics consultation in the US are healthcare workers, chaplains, or ethicists [ 2 ], while ethics consultation in Japan is often performed by physicians and ethicists. We therefore selected four experts from the fields of medicine and ethics from the US and Japan as participants (Table 1 ).…”

Section: Methodsmentioning

confidence: 99%

“…In the United States (US), ethics consultation services have rapidly expanded since the 1980s; currently, this service is provided at all hospitals with 400 or more beds. Thirty-six thousand cases are requested yearly, involving roughly 29,000 consultants [ 2 ]. Several studies on ethics consultation have been published in the US, including discussions based on case studies [ 3 , 4 ], evaluations of ethics consultation [ 5 , 6 ], and analyses of consultation recommendations and their relevant factors [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…The practice of ethics consultation has often depended on clinical ethical judgments and practical knowledge. Even in the US, 95% of the individuals performing ethics consultation have not completed any formal graduate level training [ 2 ]. Comparisons based on case studies are therefore an appropriate means of beginning to assess the similarities and differences in practical knowledge that guide ethics consultation in diverse international contexts.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Ethics Consultation: Examining how American and Japanese experts analyze an Alzheimer's case

et al. 2008

View full text Add to dashboard Cite

BackgroundFew comparative studies of clinical ethics consultation practices have been reported. The objective of this study was to explore how American and Japanese experts analyze an Alzheimer's case regarding ethics consultation.MethodsWe presented the case to physicians and ethicists from the US and Japan (one expert from each field from both countries; total = 4) and obtained their responses through a questionnaire and in-depth interviews.ResultsEstablishing a consensus was a common goal among American and Japanese participants. In attempting to achieve consensus, the most significant similarity between Japanese and American ethics consultants was that they both appeared to adopt an "ethics facilitation" approach. Differences were found in recommendation and assessment between the American and Japanese participants. In selecting a surrogate, the American participants chose to contact the grandson before designating the daughter-in-law as the surrogate decision-maker. Conversely the Japanese experts assumed that the daughter-in-law was the surrogate.ConclusionOur findings suggest that consensus building through an "ethics facilitation" approach may be a commonality to the practice of ethics consultation in the US and Japan, while differences emerged in terms of recommendations, surrogate assessment, and assessing treatments. Further research is needed to appreciate differences not only among different nations including, but not limited to, countries in Europe, Asia and the Americas, but also within each country.

show abstract

Response to Open Peer Commentaries on “Ethics Consultation in U.S. Hospitals: A National Survey”

Cited by 6 publications

References 13 publications

The Failure of the Consult Model: Why “Mediation” Should Replace “Consultation”

The Failure of the Consult Model: Why “Mediation” Should Replace “Consultation”

The IntegratedEthics^TMStaff Survey: A Tool to Evaluate and Improve Ethical Practices in Health Care

Clinical Ethics Consultation: Examining how American and Japanese experts analyze an Alzheimer's case

Contact Info

Product

Resources

About

Response to Open Peer Commentaries on “Ethics Consultation in U.S. Hospitals: A National Survey”

Cited by 6 publications

References 13 publications

The Failure of the Consult Model: Why “Mediation” Should Replace “Consultation”

The Failure of the Consult Model: Why “Mediation” Should Replace “Consultation”

The IntegratedEthicsTMStaff Survey: A Tool to Evaluate and Improve Ethical Practices in Health Care

Clinical Ethics Consultation: Examining how American and Japanese experts analyze an Alzheimer's case

Contact Info

Product

Resources

About

The IntegratedEthics^TMStaff Survey: A Tool to Evaluate and Improve Ethical Practices in Health Care