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Functions and outcomes of a clinical medical ethics committee: a review of 100 consults.
HEC Forum ; 24(2): 99-114, 2012 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-22302457
ABSTRACT
CONTEXT: Established in 1997, Summa Health System's Medical Ethics Committee (EC) serves as an educational, supportive, and consultative resource to patients/families and providers, and serves to analyze, clarify, and ameliorate dilemmas in clinical care. In 2009 the EC conducted its 100th consult. In 2002 a Palliative Care Consult Service (PCCS) was established to provide supportive services for patients/families facing advanced illness; enhance clinical decision-making during crisis; and improve pain/symptom management. How these services affect one another has thus far been unclear.

OBJECTIVES:

This study describes EC consults: types, reasons, recommendations and utilization, and investigates the impact the PCCS may have on EC consult requests or recommendations.

METHODS:

Retrospective reviews of 100 EC records explored trends and changes in types of consults, reasons for consults, and EC recommendations and utilization.

RESULTS:

There were 50 EC consults each in the 6 years pre- and post-PCCS.Differences found include: (1) a decrease in number of reasons for consult requests (133-62); (2) changes in top two reasons for EC consult requests from 'Family opposed to withdrawing life-sustaining treatment (LST)' and 'Patient capacity in question' to 'Futility' and 'Physician opposed to providing LST'; (3) changes in top two recommendations given by the EC from 'Emotional Support for Patient/Family' and 'Initiate DNR Order' to 'Comfort Care' and 'Withdraw Treatment.' Overall, 88% of recommendations were followed.

CONCLUSION:

PCCS availability and growth throughout the hospital may have influenced EC consult requests. EC consults regarding family opposition to withdrawing LST and EC recommendations for patient/family support declined.
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Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Derivación y Consulta / Comités de Ética Clínica / Ética Médica Límite: Anciano / Femenino / Humanos / Masculino / Media edad Idioma: Inglés Revista: HEC Forum Asunto de la revista: Etica / Hospitales / Jurisprudencia Año: 2012 Tipo del documento: Artículo País de afiliación: Estados Unidos