TY - JOUR
T1 - An embedded model for ethics consultation
T2 - Characteristics, outcomes, and challenges
AU - Bruce, Courtenay
AU - Peña, Adam
AU - Kusin, Betsy B.
AU - Allen, Nathan G.
AU - Smith, Martin L.
AU - Majumder, Mary A.
N1 - Funding Information:
Established more than 25 years ago, the ECS at Houston Methodist Hospital (“Methodist”) in Houston, TX, has conducted approximately 800 ethics consultations in the last 5 years at its main campus in the Texas Medical Center (900 beds). Houston Methodist ECS is supported by three faculty members from the Center for Medical Ethics and Health Policy at Baylor College of Medicine (the “Center”) and one research associate, all of whom are paid in part from a contract with Methodist. One faculty member and one research associate are new additions to the ECS, recently recruited to help staff the ECS and support its post-embedded ethics consultation volume. The faculty members have backgrounds in law, mediation, medicine, and philosophy, allowing for a rich multidisciplinary service. All three faculty members have advanced clinical ethics training that they received through full-time clinical ethics fellowships prior to their faculty appointments at the Center.
Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 2014
Y1 - 2014
N2 - Little has been written about models for clinical ethics consultation. By "model" we mean the way in which the engagement between the clinical ethics consultant, hospital staff, and other stakeholders is structured, with a key variable being the degree of integration with stakeholders within the institution or segments of the institution. We describe an innovative model of clinical ethics consultation, which we term "embedded ethics," involving embedding clinical ethics consultants within clinical specialties and subspecialties based on institutional needs and areas of clinical ethicists' expertise. Methods: The overarching methodology for this article is a case study, reporting our experience with an intervention that we evaluated using mixed methods. Results: Our results underscore the positive impact that an embedded ethics intervention can have on consultation volume and intensity, as well as clinical staff perceptions of an ethics consultation service (ECS). Conclusions: Our experience with the embedded ethics model supports several intuitions about the benefits of adopting such a model for increasing awareness (and use) of the ECS as a resource for clinicians, patients, and families and of improving clinicians' satisfaction.
AB - Little has been written about models for clinical ethics consultation. By "model" we mean the way in which the engagement between the clinical ethics consultant, hospital staff, and other stakeholders is structured, with a key variable being the degree of integration with stakeholders within the institution or segments of the institution. We describe an innovative model of clinical ethics consultation, which we term "embedded ethics," involving embedding clinical ethics consultants within clinical specialties and subspecialties based on institutional needs and areas of clinical ethicists' expertise. Methods: The overarching methodology for this article is a case study, reporting our experience with an intervention that we evaluated using mixed methods. Results: Our results underscore the positive impact that an embedded ethics intervention can have on consultation volume and intensity, as well as clinical staff perceptions of an ethics consultation service (ECS). Conclusions: Our experience with the embedded ethics model supports several intuitions about the benefits of adopting such a model for increasing awareness (and use) of the ECS as a resource for clinicians, patients, and families and of improving clinicians' satisfaction.
KW - Clinical ethics consultation
KW - Ethics committees
KW - Ethics consultation services
KW - Outcomes research
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U2 - 10.1080/23294515.2014.889775
DO - 10.1080/23294515.2014.889775
M3 - Article
AN - SCOPUS:84904461383
VL - 5
SP - 8
EP - 18
JO - AJOB Empirical Bioethics
JF - AJOB Empirical Bioethics
SN - 2329-4515
IS - 3
ER -