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Dissatisfaction with Ethics Consultations: The Anna Karenina Principle

Published online by Cambridge University Press:  12 December 2005

LAWRENCE J. SCHNEIDERMAN ,
TODD GILMER ,
HOLLY D. TEETZEL ,
DANIEL O. DUGAN ,
PAULA GOODMAN-CREWS  and
FELICIA COHN
LAWRENCE J. SCHNEIDERMAN
Affiliation:
Departments of Family and Preventive Medicine and Medicine, School of Medicine, University of California, San Diego
TODD GILMER
Affiliation:
Department of Family and Preventive Medicine at the University of California, San Diego
HOLLY D. TEETZEL
Affiliation:
Department of Family and Preventive Medicine at the University of California, San Diego
DANIEL O. DUGAN
Affiliation:
Emanuel Medical Center, Turlock, California, and Swedish Covenant Hospital, Chicago, Illinois
PAULA GOODMAN-CREWS
Affiliation:
Kaiser Permanente San Diego
FELICIA COHN
Affiliation:
University of California, Irvine School of Medicine
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Extract

In a previously published multicenter, prospective, randomized, controlled trial of more than 500 intensive care unit patients involved in conflicts over treatment decisions, ethics consultations were found to be helpful in resolving the conflicts and reducing nonbeneficial treatments. The intervention received favorable reviews by 80% of patient surrogates and more than 90% of physicians and nurses. Nevertheless, several participants in the ethics consultation process expressed dissatisfactions with the intervention. In this paper, we report our efforts to determine the factors associated with these negative responses in hopes that we might provide insights of future use to ethics consultants.We gratefully acknowledge the contributions of Jeffrey Blustein, Kathleen B. Briggs, Ronald Cranford, Glen I. Komatsu, and Ernle W.D. Young to the original randomized controlled trial phase of this research. Grant support came from the Agency for Healthcare Research and Quality, 1 R01 HS10251.

Type
Ethics Committees at Work
Information
Cambridge Quarterly of Healthcare Ethics , Volume 15 , Issue 1 , January 2006 , pp. 101 - 106
Copyright
© 2006 Cambridge University Press

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