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"Ethics consultation"

Paul L Schneider, Zhaoping Li
OBJECTIVE: To provide a thorough analysis of the range of ethical concerns that may present in relation to the care of the morbidly obese inpatient over the course of several years of care. METHODS: A narrative of the patient's complex medical care is given, with particular attention to the recommendations of three separate ethics committee consultations that were sought by his health care providers. An ethical analysis of the relevant issues is given within the Principles of Biomedical Ethics framework, highlighting the principles of autonomy, beneficence, non-maleficence, and justice...
2016: Narrative Inquiry in Bioethics
M Gruß, F Salomon
In intensive care units far-reaching decisions are often made at short notice that require the consent of the informed patient. If this is not possible due to the patient's condition, physicians and legal representatives must ascertain the previously expressed or presumed will of the patient and act accordingly. The legal principles are specified in the Patient Advance Directives Act and the Patient Rights Act. Any indications for medical treatment need a clearly defined aim of the therapy, which can be questioned during the progress of the disease...
September 29, 2016: Der Anaesthesist
Virginia L Bartlett, Stuart G Finder
BACKGROUND: An ongoing challenge for clinical ethics consultation is learning how colleagues in other healthcare professions understand, make use of, and evaluate clinical ethics consultation services. AIM: In pursuing such knowledge as part of clinical ethics consultation service quality assessment, clinical ethics consultation services can learn important information about the issues and concerns that prompt colleagues to request ethics consultation. Such knowledge allows for greater outreach, education, and responsiveness by clinical ethics consultation services to the concerns of clinician colleagues...
August 11, 2016: Nursing Ethics
(no author information available yet)
The Report of the Ethics Committee, 2015, provides information on activities of the Ethics Committee and Ethics Office during that year. In 2015, the Ethics Office and Committee continued their work of adjudication, ethics education, and ethics consultations. The Ethics Committee adopted minor changes to its "Rules and Procedures" to increase the efficiency of the adjudication process. These changes were approved by the APA Board of Directors to become effective on March 1, 2016. The Independent Review Report by David H...
July 2016: American Psychologist
Maximilian Schochow, Giovanni Rubeis, Florian Steger
The executive board of the Academy for Ethics in Medicine (AEM) and two AEM working groups formulated standards and recommendations for clinical ethics consultation in 2010, 2011, and 2013. These guidelines comply with the international standards like those set by the American Society for Bioethics and Humanities. There is no empirical data available yet that could indicate whether these standards and recommendations have been implemented in German hospitals. This desideratum is addressed in the present study...
August 2, 2016: Science and Engineering Ethics
Joschka Haltaufderheide, Marcel Mertz, Jochen Vollmann, Jan Schildmann
No abstract text is available yet for this article.
September 2016: American Journal of Bioethics: AJOB
Jeremy R Garrett
No abstract text is available yet for this article.
September 2016: American Journal of Bioethics: AJOB
Robert Ranisch, Cordula Brand
No abstract text is available yet for this article.
September 2016: American Journal of Bioethics: AJOB
George J Agich
No abstract text is available yet for this article.
September 2016: American Journal of Bioethics: AJOB
Morten Magelssen, Reidar Pedersen, Reidun Førde
When clinical ethics committee members discuss a complex ethical dilemma, what use do they have for normative ethical theories? Members without training in ethical theory may still contribute to a pointed and nuanced analysis. Nonetheless, the knowledge and use of ethical theories can play four important roles: aiding in the initial awareness and identification of the moral challenges, assisting in the analysis and argumentation, contributing to a sound process and dialogue, and inspiring an attitude of reflexivity...
September 2016: American Journal of Bioethics: AJOB
David M Chooljian, James Hallenbeck, Stephen C Ezeji-Okoye, Robert Sebesta, Hasan Iqbal, Ware G Kuschner
Hospital ethics committees (HECs) are typically charged with addressing ethical disputes, conflicts, and dilemmas that arise in the course of patient care. HECs are not widely viewed as having a therapeutic role for health care professionals who experience psychological distress or anticipatory grief in the course of discharging professional duties. A case is presented in which an ethics consultation was requested, chiefly, to secure emotional support for health care professionals who had been asked by a patient to discontinue life-sustaining treatments...
July 2016: Journal of Social Work in End-of-life & Palliative Care
Adam Peña, Trevor Bibler
Mr. M is an eighty-five-year-old who presented to the hospital with congestive heart failure exacerbation, pneumonia, altered mental status, and sepsis. A physician determines that he lacks capacity, and the team in the intensive care unit looks to the patient's daughter, Celia, as his surrogate decision-maker because she is named as an agent in his medical power of attorney form. While in the ICU, Mr. M suffers acute respiratory distress secondary to pneumonia and thus requires intubation. Celia accepts several life-sustaining interventions, but she sporadically refuses other medically indicated therapies...
July 2016: Hastings Center Report
Daryl Pullman, Kathleen Hodgkinson
This article discusses the response of our ethics consultation service to an exceptional request by a patient to have his implantable cardioverter defibrillator (ICD) removed. Despite assurances that the device had saved his life on at least two occasions, and cautions that without it he would almost certainly suffer a potentially lethal cardiac event within 2 years, the patient would not be swayed. Although the patient was judged to be competent, our protracted consultation process lasted more than 8 months as we consulted, argued with, and otherwise cajoled him to change his mind, all to no avail...
August 2016: American Journal of Bioethics: AJOB
(no author information available yet)
An ethics consult was scheduled for the following day. Prior to the consult, Mr. Hope subsequently decompensated and was transferred to the local hospital. The ethics consultation service continued with the ethics consult to discuss the ethical concerns of the medical staff but in particular to create an open forum for the staff to process their moral distress over the care of this patient and to come to an agreed-on plan on how they would proceed should the resident code. The patient never returned to the long-term care setting...
July 2016: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
Debjani Mukherjee
Mr. Hope's family's expectations and his staff's concerns raise important issues about surrogate decisionmaking, communication regarding prognosis, and staff angst. Unfortunately, Mr. Hope himself is unable to reliably understand and communicate his preferences, especially for complex medical decisions, so the ethics consultant is left to negotiate the disagreement between his family and his healthcare providers, who presumably both believe they are acting in his best interest.
July 2016: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
Jason Lesandrini, Carol O'Connell
Ethical issues in long-term care settings, although having received attention in the literature, have not in our opinion received the appropriate level they require. Thus, we applaud the Cambridge Quarterly for publishing this case. We can attest to the significance of ethical issues arising in long-term care facilities, as Mr. Hope's case is all too familiar to those practicing in these settings. What is unique about this case is that an actual ethics consult was made in a long-term care setting. We have seen very little in the published literature on the use of ethics structures in long-term care populations...
July 2016: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
Tracy Brazg, Taryn Lindhorst, Denise Dudzinski, Benjamin Wilfond
The idea of patient advocacy as a function of clinical ethics consultation (CEC) has been debated in the bioethics literature. In particular, opinion is divided as to whether patient advocacy inherently is in conflict with the other duties of the ethics consultant, especially that of impartial mediator. The debate is complicated, however, because patient advocacy is not uniformly conceptualized. This article examines two literatures that are crucial to understanding patient advocacy in the context of bioethical deliberations: the CEC literature and the literature on advocacy in the social work profession...
2016: Journal of Clinical Ethics
Sally E Bliss, Jane Oppenlander, Jacob M Dahlke, Gordon J Meyer, Eva M Williford, Robert C Macauley
For all of the emphasis on quality improvement-as well as the acknowledged overlap between assessment of the quality of healthcare services and clinical ethics-the quality of clinical ethics consultation has received scant attention, especially in terms of empirical measurement. Recognizing this need, the second edition of Core Competencies for Health Care Ethics Consultation1 identified four domains of ethics quality: (1) ethicality, (2) stakeholders' satisfaction, (3) resolution of the presenting conflict/dilemma, and (4) education that translates into knowledge...
2016: Journal of Clinical Ethics
Bethany Spielman, Christine Gorka, Keith Miller, Carolyn A Pointer, Barbara Hinze
BACKGROUND: Clinical ethics consultants are expected to "reduce disparities, discrimination, and inequities when providing consultations," but few studies about inequities in ethics consultation exist.1 The objectives of this study were (1) to determine if there were racial or gender differences in the timing of requests for ethics consultations related to limiting treatment, and (2) if such differences were found, to identify factors associated with that difference and the role, if any, of ethics consultants in mitigating them...
2016: Journal of Clinical Ethics
Salla Saxén
This qualitative social scientific interview study delves into the ways in which professional vision is constructed in clinical ethics consultation (CEC). The data consist of 11 semi-structured interviews that were conducted with clinical ethics consultants currently working in hospitals in one major urban area in the U.S. The interviews were analyzed with the qualitative research method of critical discourse analysis, with a focus on identifying the cultural structures of knowledge that shape CEC as a professional practice...
2016: Journal of Clinical Ethics
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