Report of 255 Clinical Ethics Consultations and Review of the Literature

Swetz, Keith M.; Crowley, Mary Eliot; Hook, C. Christopher; Mueller, Paul S.
June 2007
Mayo Clinic Proceedings;Jun2007, Vol. 82 Issue 6, p686
Academic Journal
OBJECTIVE: To review clinical ethics consultations at a tertiary care academic medical center. METHODS: We retrospectively reviewed all ethics consultations (and associated patient medical records) conducted at the Mayo Clinic in Rochester, Minn, between April 6, 1995, and December 31, 2005. RESULTS: Of the 255 consultations, 101 (40%) reviewed intensive care unit care, 103 (40%) involved patients who died during hospitalization, and 174 (68%) were requested by physicians. The most common primary diagnoses of the patients involved were malignancy (18%, n=47), neurologic disease (18%, n=47), and cardiovascular disease (17%, n=43). Most cases involved multiple issues: patient competency and decision-making capacity (82%, n=208), staff member disagreement with care plans (76%, n=195), end-of-life and quality-of-life issues (60%, n=154), and goals of care and futility (54%, n=138). Withholding or withdrawing measures was the focus of 132 (52%) of the consultations. We also identified previously published reports of ethics consultations and compared the findings of those reports with ours. CONCLUSIONS: Despite advances in medicine, the nature of ethical dilemmas remains relatively unchanged. Issues of communication, family conflict, and futility continue to give rise to ethical quandaries.


Related Articles

  • PRACTICE MANAGEMENT Q&As.  // Medical Economics;3/18/2005, Vol. 82 Issue 6, p66 

    Presents a question and answer advisory involving medical practice. Suitable charges on patients or their insurers in the negotiated rate on the laboratory work; Appropriateness of the practice bond employees to handle money; Effective ways to advertise the sale of practice.

  • Update Intensivmedizin. Knapp, J.; Bernhard, M.; Hofer, S.; Popp, E.; Weigand, M.A. // Anaesthesist;May2014, Vol. 63 Issue 5, p429 

    No abstract available.

  • Your doctor is in. Manson, Joanne E. // Glamour;Oct2005, Vol. 103 Issue 10, p128 

    Presents a question and answer advisory on health issues. Considerations before getting a second opinion; Necessity of second opinion; Importance of consulting other physician.

  • The development of a descriptive evaluation tool for clinical ethics case consultations. Pedersen, R.; Hurst, S. A.; Schildmann, J.; Schuster, S.; Molewijk, B. // Clinical Ethics;2010, Vol. 5 Issue 3, p136 

    There is growing interest in clinical ethics. However, we still have sparse knowledge about what is actually going on in the everyday practice of clinical ethics consultations. This paper introduces a descriptive evaluation tool to present, discuss and compare how clinical ethics case...

  • Consulting with male patients. Jacobi, Tillmann // GP: General Practitioner;6/12/2009, p46 

    The article provides information on the factors that involved in consulting male patients. It notes that consultation with man is potentially important chance to explore more aspects of their health behavior and state of health or well-being such as drinking and smoking. Moreover, to consider...

  • Use of the Medical Ethics Consultation Service in a Busy Level I Trauma Center: Impact on Decision-Making and Patient Care. Johnson, Laura S.; Lesandrini, Jason; Rozycki, Grace S. // American Surgeon;Jul2012, Vol. 78 Issue 7, p735 

    The purposes of this study were to assess reasons for consultation of the Ethics Consultation Service for trauma patients and how consultations impacted care. We conducted a review of ethics consultations at a Level I trauma center from 2001 to 2010. Data included patient demographics, etiology...

  • MEWS to e-MEWS: From a Paper-Based to an Electronic Clinical Decision Support System. O'Kane, Tom; O'Donoghue, John; Gallagher, Joe; Aftab, A.; Casey, Aveline; Angove, Philip; Torres, Javier; Courtney, Garry // Proceedings of the European Conference on Information Management;2010, p301 

    It is now well established that many patients already in hospital can suddenly become acutely ill but experience delayed recognition of their physiological deterioration resulting in late referral to critical care or in some cases death. In recent years there has been significant growth in the...

  • Scottish Centre for Telehealth. Peterkin, Gordon // Health Information on the Internet;Aug2008, Issue 64, p3 

    The article focuses on Scottish Centre for Telehealth (SCT), a centre of expertise that defines and disseminates best practice and develops standards, protocols, and processes to support telehealth solutions. The world's first trial of a revolutionary new way of providing healthcare is being...

  • Consultation skills: Using the BATHE technique. Walton, Ian // Independent Nurse;3/2/2009, p49 

    The article features the attributes and significance of BATHE technique to consultation skills of health professionals in Great Britain. General practitioners often encounter problems in the consultation process of patients because of several factors to be considered in diagnosing and analyzing...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics