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Clinical ethics case consultation in a university department of cardiology and intensive care: a descriptive evaluation of consultation protocols
- Source :
- BMC Medical Ethics, Vol 22, Iss 1, Pp 1-12 (2021), BMC Medical Ethics
- Publication Year :
- 2021
- Publisher :
- BMC, 2021.
-
Abstract
- Background Clinical ethics case consultations (CECCs) provide a structured approach in situations of ethical uncertainty or conflicts. There have been increasing calls in recent years to assess the quality of CECCs by means of empirical research. This study provides detailed data of a descriptive quantitative and qualitative evaluation of a CECC service in a department of cardiology and intensive care at a German university hospital. Methods Semi-structured document analysis of CECCs was conducted in the period of November 1, 2018, to May 31, 2020. All documents were analysed by two researchers independently. Results Twenty-four CECCs were requested within the study period, of which most (n = 22; 92%) had been initiated by physicians of the department. The patients were an average of 79 years old (R: 43–96), and 14 (58%) patients were female. The median length of stay prior to request was 12.5 days (R: 1–65 days). The most frequent diagnoses (several diagnoses possible) were cardiology-related (n = 29), followed by sepsis (n = 11) and cancer (n = 6). Twenty patients lacked decisional capacity. The main reason for a CECC request was uncertainty about the balancing of potential benefit and harm related to the medically indicated treatment (n = 18). Further reasons included differing views regarding the best individual treatment option between health professionals and patients (n = 3) or between different team members (n = 3). Consensus between participants could be reached in 18 (75%) consultations. The implementation of a disease specific treatment intervention was recommended in five cases. Palliative care and limitation of further disease specific interventions was recommended in 12 cases. Conclusions To the best of our knowledge, this is the first in-depth evaluation of a CECC service set up for an academic department of cardiology and intensive medical care. Patient characteristics and the issues deliberated during CECC provide a starting point for the development and testing of more tailored clinical ethics support services and research on CECC outcomes.
- Subjects :
- medicine.medical_specialty
Health (social science)
Palliative care
Critical Care
Medical philosophy. Medical ethics
Health Personnel
Psychological intervention
Cardiology
0603 philosophy, ethics and religion
Ethics consultation
03 medical and health sciences
0302 clinical medicine
Empirical research
Clinical ethics
Academic department
Internal medicine
Intensive care
medicine
Intensive care - document analysis
Humans
030212 general & internal medicine
Medical diagnosis
Referral and Consultation
Ethics Consultation
Aged
R723-726
business.industry
Health Policy
Research
06 humanities and the arts
Evaluation research
Issues, ethics and legal aspects
Ethics, Clinical
Philosophy of medicine
Female
060301 applied ethics
business
Subjects
Details
- Language :
- English
- ISSN :
- 14726939
- Volume :
- 22
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Medical Ethics
- Accession number :
- edsair.doi.dedup.....65bd6478e63daafc624155cd8b1f1861