Setting Expectations for ECMO: Improving Communication Between Clinical Teams and Decision Makers

Ashley L. Stephens; Courtenay R. Bruce

doi:10.14797/mdcj-14-2-120

Setting Expectations for ECMO: Improving Communication Between Clinical Teams and Decision Makers

Ashley L. Stephens, Courtenay R. Bruce

Research output: Contribution to journal › Review article › peer-review

33 Scopus citations

Abstract

Transplant medicine is fraught with clinical-ethical issues. It is not uncommon to have ethicists on transplant teams to help navigate ethically complex cases and ethical questions. Clinical ethicists work in hospitals and/or other healthcare institutions identifying and addressing value-laden conflict and ethical uncertainties. As ethicists, we set out to describe our process and involvement in cases involving extracorporeal membrane oxygenation (ECMO). Our work centers on monitoring and optimizing communication among clinicians, families, and patients, with the goals of (1) aligning patient/family understanding of the nature and purpose of ECMO while encouraging realistic expectations for possible outcomes, and (2) proactively mitigating the moral distress of providers involved in complex ECMO cases. We close with recommendations for how to measure the impact of ethicists' involvement in ECMO cases.

Original language	English (US)
Pages (from-to)	120-125
Number of pages	6
Journal	Methodist DeBakey cardiovascular journal
Volume	14
Issue number	2
DOIs	https://doi.org/10.14797/mdcj-14-2-120
State	Published - Apr 1 2018

Keywords

ECMO
decision making
end of life
ethics
extracorporeal membrane oxygenation
mechanical circulatory support
Humans
Extracorporeal Membrane Oxygenation/adverse effects
Male
Respiratory Distress Syndrome, Adult/diagnosis
Professional Role
Patient Selection/ethics
Terminal Care/ethics
Oxygenators, Membrane
Clinical Decision-Making/ethics
Patient Care Team/ethics
Attitude of Health Personnel
Risk Assessment
Risk Factors
Health Knowledge, Attitudes, Practice
Ethicists/psychology
Interdisciplinary Communication
Professional-Family Relations/ethics
Aged
Withholding Treatment/ethics

ASJC Scopus subject areas

General Medicine

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10.14797/mdcj-14-2-120

Cite this

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title = "Setting Expectations for ECMO: Improving Communication Between Clinical Teams and Decision Makers",

abstract = "Transplant medicine is fraught with clinical-ethical issues. It is not uncommon to have ethicists on transplant teams to help navigate ethically complex cases and ethical questions. Clinical ethicists work in hospitals and/or other healthcare institutions identifying and addressing value-laden conflict and ethical uncertainties. As ethicists, we set out to describe our process and involvement in cases involving extracorporeal membrane oxygenation (ECMO). Our work centers on monitoring and optimizing communication among clinicians, families, and patients, with the goals of (1) aligning patient/family understanding of the nature and purpose of ECMO while encouraging realistic expectations for possible outcomes, and (2) proactively mitigating the moral distress of providers involved in complex ECMO cases. We close with recommendations for how to measure the impact of ethicists' involvement in ECMO cases.",

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author = "Stephens, \{Ashley L.\} and Bruce, \{Courtenay R.\}",

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AU - Bruce, Courtenay R.

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PY - 2018/4/1

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N2 - Transplant medicine is fraught with clinical-ethical issues. It is not uncommon to have ethicists on transplant teams to help navigate ethically complex cases and ethical questions. Clinical ethicists work in hospitals and/or other healthcare institutions identifying and addressing value-laden conflict and ethical uncertainties. As ethicists, we set out to describe our process and involvement in cases involving extracorporeal membrane oxygenation (ECMO). Our work centers on monitoring and optimizing communication among clinicians, families, and patients, with the goals of (1) aligning patient/family understanding of the nature and purpose of ECMO while encouraging realistic expectations for possible outcomes, and (2) proactively mitigating the moral distress of providers involved in complex ECMO cases. We close with recommendations for how to measure the impact of ethicists' involvement in ECMO cases.

AB - Transplant medicine is fraught with clinical-ethical issues. It is not uncommon to have ethicists on transplant teams to help navigate ethically complex cases and ethical questions. Clinical ethicists work in hospitals and/or other healthcare institutions identifying and addressing value-laden conflict and ethical uncertainties. As ethicists, we set out to describe our process and involvement in cases involving extracorporeal membrane oxygenation (ECMO). Our work centers on monitoring and optimizing communication among clinicians, families, and patients, with the goals of (1) aligning patient/family understanding of the nature and purpose of ECMO while encouraging realistic expectations for possible outcomes, and (2) proactively mitigating the moral distress of providers involved in complex ECMO cases. We close with recommendations for how to measure the impact of ethicists' involvement in ECMO cases.

KW - ECMO

KW - decision making

KW - end of life

KW - ethics

KW - extracorporeal membrane oxygenation

KW - mechanical circulatory support

KW - Humans

KW - Extracorporeal Membrane Oxygenation/adverse effects

KW - Male

KW - Respiratory Distress Syndrome, Adult/diagnosis

KW - Professional Role

KW - Patient Selection/ethics

KW - Terminal Care/ethics

KW - Oxygenators, Membrane

KW - Clinical Decision-Making/ethics

KW - Patient Care Team/ethics

KW - Attitude of Health Personnel

KW - Risk Assessment

KW - Risk Factors

KW - Health Knowledge, Attitudes, Practice

KW - Ethicists/psychology

KW - Interdisciplinary Communication

KW - Professional-Family Relations/ethics

KW - Aged

KW - Withholding Treatment/ethics

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M3 - Review article

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AN - SCOPUS:85055628578

SN - 1947-6094

VL - 14

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JO - Methodist DeBakey cardiovascular journal

JF - Methodist DeBakey cardiovascular journal

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ER -

Setting Expectations for ECMO: Improving Communication Between Clinical Teams and Decision Makers

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