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"Ethics consultation"

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https://www.readbyqxmd.com/read/29079198/the-internist-as-clinical-ethics-consultant-an-antidote-to-the-barbarism-of-specialisation-in-hospital-practice
#1
D Real de Asúa, P Rodriguez Del Pozo, J J Fins
The development of hospital clinical ethics in Spain depends almost exclusively on the healthcare ethics committees, which have been criticized for a lack of proximity to the patient's bedside in day-to-day ethical conflicts and for their scarce practical operation, reflected in the low number of consultations they receive. In this study, we reflect on the need to change the current healthcare model in clinical ethics so as to reactivate it and call attention to the essential role of internists as the engine for this change...
October 25, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/29063997/clinical-ethics-consultation-after-god-implications-for-advocacy-and-neutrality
#2
J Clint Parker
In After God: Morality and Bioethics in a Secular Age, H. Tristram Engelhardt, Jr. explores the broad implications for moral reasoning once a culture has lost a God's-eye perspective. In this paper, I focus on the implications of Engelhardt's views for clinical ethics consultation. I begin by examining the question of whether clinical ethics consultants (CECs) should advocate a particular viewpoint and/or process during consultations or adopt a neutral stance. I then examine the implications of Engelhardt's views for this question...
October 24, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/29059693/-ethics-consultation-on-the-icu-the-clinically-oriented-method-of-counselling
#3
Gerald Neitzke
When ethical conflicts arise on the ICU, an ethics case consultation is useful. The aim of this consult is a qualified reflection of the moral values, convictions and assumptions involved in the case. The "clinically oriented method of counselling" provides an adequate structure for case consultations on the ICU. The moral assumptions and estimations contained in medical indications, prognosis, therapeutic aims, risk-benefit assessment and issues of quality of life are discussed and a consensus is sought for...
October 23, 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29031322/cultural-factors-in-ethics-consultations
#4
EDITORIAL
Désirée A Lie, Jack B Fu, Patrick Schmitt, Eric Kodish, Debjani Mukherjee
No abstract text is available yet for this article.
October 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28975473/why-are-there-so-few-ethics-consults-in-children-s-hospitals
#5
Brian Carter, Manuel Brockman, Jeremy Garrett, Angie Knackstedt, John Lantos
In most children's hospitals, there are very few ethics consultations, even though there are many ethically complex cases. We hypothesize that the reason for this may be that hospitals develop different mechanisms to address ethical issues and that many of these mechanisms are closer in spirit to the goals of the pioneers of clinical ethics than is the mechanism of a formal ethics consultation. To show how this is true, we first review the history of collaboration between philosophers and physicians about clinical dilemmas...
October 3, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28949894/the-use-of-an-online-comment-system-in-clinical-ethics-consultation
#6
Katrina Hauschildt, Trisha K Paul, Raymond De Vries, Lauren B Smith, Christian J Vercler, Andrew G Shuman
BACKGROUND: Although a mechanism for resolving ethical issues in patient care is required for accreditation of American hospitals, there are no formal qualifications for providing clinical ethics consultation (CEC), and there remains great variability in the composition of ethics committees and consult services. Consequently, the quality of CEC also varies depending on the qualifications of those performing CEC services and the format of CEC utilized at an institution. Our institution implemented an online CEC comment system to build upon existing practices to promote consistency and broad consensus in CEC services and enable quality assurance...
July 2017: AJOB Empirical Bioethics
https://www.readbyqxmd.com/read/28949846/growing-an-ethics-consultation-service-a-longitudinal-study-examining-two-decades-of-practice
#7
Christine Gorka, Jana M Craig, Bethany J Spielman
BACKGROUND: Little is known about what factors may contribute to the growth of a consultation service or how a practice may change or evolve across time. METHODS: This study examines data collected from a busy ethics consultation service over a period of more than two decades. RESULTS: We report a number of longitudinal findings that represent significant growth in the volume of ethics consultation requests from 19 in 1990 to 551 in 2013, as well as important changes in the patient population for which ethics help is requested...
April 2017: AJOB Empirical Bioethics
https://www.readbyqxmd.com/read/28949838/the-interactions-of-canadian-ethics-consultants-with-health-care-managers-and-governing-boards-during-times-of-crisis
#8
Chris Kaposy, Victor Maddalena, Fern Brunger, Daryl Pullman, Richard Singleton
BACKGROUND: Health care organizations can be very complex, and are often the setting for crisis situations. In recent years, Canadian health care organizations have faced large-scale systemic medical errors, a nation-wide generic injectable drug shortage, iatrogenic infectious disease outbreaks, and myriad other crises. These situations often have an ethical component that ethics consultants may be able to address. Organizational leaders such as health care managers and governing boards have responsibilities to oversee and direct the response to crisis situations...
April 2017: AJOB Empirical Bioethics
https://www.readbyqxmd.com/read/28948836/effect-of-simulation-on-undergraduate-nursing-students-knowledge-of-nursing-ethics-principles
#9
Mary Broderick Donnelly, Trisha Leann Horsley, William H Adams, Peggy Gallagher, C Dawn Zibricky
Background Undergraduate nursing education standards include acquisition of knowledge of ethics principles and the prevalence of health-care ethical dilemmas mandates that nursing students study ethics. However, little research has been published to support best practices for teaching/learning ethics principles. Purpose This study sought to determine if participation in an ethics consultation simulation increased nursing students' knowledge of nursing ethics principles compared to students who were taught ethics principles in the traditional didactic format...
January 1, 2017: Canadian Journal of Nursing Research, Revue Canadienne de Recherche en Sciences Infirmières
https://www.readbyqxmd.com/read/28930709/responding-to-moral-distress-and-ethical-concerns-at-the-intersection-of-medical-illness-and-unmet-mental-health-needs
#10
Donna D McKlindon, Pamela Nathanson, Chris Feudtner
Some of the most difficult clinical ethics consultations involve patients who have both medical and mental health needs, as these cases can result in considerable moral distress on the part of the bedside staff. In this article we examine the issues that such consults raise through the illustrative example of a particular case: several years ago our ethics consultation service received a request from a critical care attending physician who was considering a rarely performed psychosurgical intervention to address intractable and life-threatening agitation and aggression in an adolescent patient for whom standard treatments had proven unsuccessful...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28837011/a-survey-of-hospital-ethics-structures-in-ontario
#11
Jonathan Breslin
In response to the growing recognition of the prevalence of ethical issues in clinical care, hospitals in Canada began forming ethics committees in the 1980s. Studies showed significant growth in the prevalence of ethics committees over the ensuing decade. Although the limited studies available suggest that ethics committees have become very prevalent in Canadian hospitals, hospital ethics services have evolved in recent years to include a wider range of structures. In some cases, these structures may work in conjunction with an ethics committee, but in other cases they may replace ethics committees...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28780527/assessment-of-orientation-practices-for-ethics-consultation-at-harvard-medical-school-affiliated-hospitals
#12
Danish Zaidi, Jennifer C Kesselheim
BACKGROUND: Few studies have been conducted to assess the quality of orientation practices for ethics advisory committees that conduct ethics consultation. This survey study focused on several Harvard teaching hospitals, exploring orientation quality and committee members' self-evaluation in the American Society of Bioethics and Humanities (ASBH) ethics consultation competencies. METHODS: We conducted a survey study that involved 116 members and 16 chairs of ethics advisory committees, respectively (52% and 62...
August 5, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28776144/-validation-of-medical-ethical-decisions-at-the-bedside-by-the-autopsy-experience-of-the-ethics-committee-at-the-stuttgart-clinic
#13
REVIEW
A Bosse, C Schupp
BACKGROUND: Ethics consultations in a clinical setting can be challenging, specifically with respect to limiting therapeutic interventions in terminally ill patients. Some decisions will even be controversial. OBJECTIVE: Can a clinical autopsy be used to confirm the recommendations given by the ethics committee, i. e. limitation of therapy to palliative care? MATERIAL AND METHODS: We report an exemplary case of a patient with endocarditis and subsequent septic cerebral infarction...
September 2017: Der Pathologe
https://www.readbyqxmd.com/read/28751469/ethics-consultation-in-paediatric-and-adult-emergency-departments-an-assessment-of-clinical-ethical-learning-and-resource-needs
#14
Keith A Colaco, Alanna Courtright, Sandra Andreychuk, Andrea Frolic, Ji Cheng, April Jacqueline Kam
OBJECTIVE: We sought to understand ethics and education needs of emergency nurses and physicians in paediatric and adult emergency departments (EDs) in order to build ethics capacity and provide a foundation for the development of an ethics education programme. METHODS: This was a prospective cross-sectional survey of all staff nurses and physicians in three tertiary care EDs. The survey tool, called Clinical Ethics Needs Assessment Survey, was pilot tested on a similar target audience for question content and clarity...
July 27, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28749050/-please-amputate-my-child-s-arms
#15
Mary Devereaux, Dennis John Kuo
Jeremy sustained bilateral complete brachial plexus injuries in an auto collision on an icy road a month before his third birthday. The accident rendered both upper extremities completely flail and insensate: he has no motor or sensory function of his shoulders, elbows, wrists, or digits. Jeremy does, however, have normal function of the lower extremities. Physical therapists have worked with the child for over a year with no noted improvement in arm function. Jeremy falls frequently, causing injury to his face and head, and occasionally, his arms get twisted or caught in his crib and his fingers turn blue...
July 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28674939/the-care-dialog-the-ethics-of-care-approach-and-its-importance-for-clinical-ethics-consultation
#16
Patrick Schuchter, Andreas Heller
Ethics consultation in institutions of the healthcare system has been given a standard form based on three pillars: education, the development of guidelines and concrete ethics consultation in case conferences. The spread of ethics committees, which perform these tasks on an organizational level, is a remarkable historic achievement. At the same time it cannot be denied that modern ethics consultation neglects relevant aspects of care ethics approaches. In our essay we present an "ethics of care" approach as well as an empirical pilot project-"Ethics from the bottom up"-which organizes ethics consultation based on this focus...
July 3, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28666533/the-ethics-consultant
#17
Ana Zapatero Ferrándiz, Gerard Colomar Pueyo, Irene Dot Jordana, José Felipe Solsona Durán
No abstract text is available yet for this article.
June 27, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28661743/law-is-not-enough-the-importance-of-ethics-consultation-in-complex-cases
#18
Joan M Henriksen, Megan S Remtema, Kevin Whitford
No abstract text is available yet for this article.
July 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/28661281/informed-consent-is-the-essence-of-capacity-assessment
#19
Jeffrey P Spike
Informed consent is the single most important concept for understanding decision-making capacity. There is a steady pull in the clinical world to transform capacity into a technical concept that can be tested objectively, usually by calling for a psychiatric consult. This is a classic example of medicalization. In this article I argue that is a mistake, not just unnecessary but wrong, and explain how to normalize capacity assessment. Returning the locus of capacity assessment to the attending, the primary care doctor, and even to ethics consultation in today's environment will require a substantial effort to undo a strong but illusory impression of capacity assessment...
March 2017: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/28644789/what-is-the-role-of-ethics-consultation-in-the-moral-habitability-of-health-care-environments
#20
Wendy Austin
Ethics consultation has traditionally focused on the provision of expert guidance to health care professionals when challenging quandaries arise in clinical cases. Its role, however, is expanding as demands on health care organizations are negatively impacting their moral habitability. A sign of this impact can be seen in the moral distress experienced by staff and administrators, such that some leave their positions and their organizations. Ethics consultation, more broadly conceived, can be a major asset in ensuring that ethical practice is meaningfully supported, that moral distress is mitigated, and that the organizational environment is morally habitable...
June 1, 2017: AMA Journal of Ethics
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