Frequency of ethical issues on a hospitalist teaching service at an Urban, tertiary care center

Matthew W. McCarthy, Diego Real De Asua, Ezra Gabbay, Paul J. Christos, Joseph J. Fins

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Little is known about the daily ethical conflicts encountered by hospitalists that do not prompt a formal clinical ethics consultation. We describe the frequencies of ethical issues identified during daily rounds on hospitalist teaching services at a metropolitan, tertiary-care, teaching hospital. Data were collected from September 2017 through May 2018 by two attending hospitalists from the ethics committee who were embedded on rounds. A total of 270 patients were evaluated and 113 ethical issues were identified in 77 of those patients. These issues most frequently involved discussions about goals of care, treatment refusals, decision-making capacity, discharge planning, cardiopulmonary resuscitation status, and pain management. Only five formal consults were brought to the Hospital Ethics Committee for these 270 patients. Our data are the first prospective description of ethical issues arising on academic hospitalist teaching services and are an important step in the development of a targeted ethics curriculum for hospitalists.

Original languageEnglish (US)
Pages (from-to)290
Number of pages1
JournalJournal of hospital medicine
Volume14
Issue number5
DOIs
StatePublished - May 2019

ASJC Scopus subject areas

  • Leadership and Management
  • Internal Medicine
  • Fundamentals and skills
  • Health Policy
  • Care Planning
  • Assessment and Diagnosis

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