OBJECTIVE
To describe ethics consultations at a single institution that has a mandatory ethics
consultation policy.
PATIENTS AND METHODS
We retrospectively reviewed the medical records of all adult patients who were admitted
to the intensive care unit at Columbia University Medical Center and had an ethics
consultation between August 1, 2006, and July 31, 2007. All mandatory and nonmandatory
ethics consultations were reviewed. Patient diagnosis, prognosis, presence of do-not-resuscitate
order, presence of written advance directives, reason for the ethics consultation,
and survival data were collected. The number of ethics consultations hospital-wide
from January 1, 2000, to December 31, 2007, was collected.
RESULTS
The total number of mandatory and nonmandatory ethics consultations requested was
168. Of these consultations, 108 (64%) were considered mandatory, and 60 (36%) were
considered nonmandatory. Between January 1, 2000, and December 31, 2007, the total
number of ethics consultations increased 84%.
CONCLUSION
The increase in the total number of ethics consultations is interpreted as a positive
outcome of the mandatory policy. The mandatory ethics consultation policy has possibly
increased exposure to ethics consultant-physician interactions, increased learning
for physicians, and raised awareness among physicians and nurses of potential ethics
assistance.
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Article Info
Footnotes
Funding for this research was provided by the Department of Anesthesiology, Columbia University, New York, NY.
Dr Wahlander is on the speaker's bureau of Hospira, the company that sells dexmedetomidine (Precedex), and receives honoraria less than $10,000 per year.
Identification
Copyright
© 2009 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
