Community hospital ethics consultation: evaluation and comparison with a university hospital service

Am J Med. 1992 Apr;92(4):346-51. doi: 10.1016/0002-9343(92)90262-a.


Background: Ethics consultants may improve patient care by responding to physician requests for assistance with problems they identify as ethical issues.

Objective: To examine three aspects of ethics consultation: the clinical questions asked; the helpfulness of the consultation to requesting physicians; and the differences between consultations performed at a community teaching hospital and those performed at a university hospital.

Settings: A community teaching hospital and a university teaching hospital.

Subjects: Physicians who formally requested ethics consultations in both hospitals and the patients for whom they requested them.

Methods: Over 2 years (January 1, 1988, to December 31, 1989), we prospectively evaluated a newly established clinical ethics consultation service in a community teaching hospital using confidentially completed, pretested, structured questionnaires, and compared our data with previously reported university hospital data.

Results: During the 2-year study, 104 consultation requests were received from 68 physicians in eight departments. Requesters most often requested consultation about deciding to forego life-sustaining treatment (74%), resolving disagreements (46%), and assessing patient competence (30%). Requesters found the consultation "very helpful" or "helpful" in one or more aspects of patient care in 86% of cases, or in one or more aspects of physician education in 86% of cases. These data are similar to university hospital data.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Advance Directives
  • Aged
  • Aged, 80 and over
  • Attitude of Health Personnel
  • Bioethical Issues
  • Child
  • Child, Preschool
  • Ethicists*
  • Ethics Consultation*
  • Ethics, Clinical*
  • Ethics, Medical*
  • Evaluation Studies as Topic
  • Female
  • Hospitals, Community / standards*
  • Hospitals, University / standards*
  • Humans
  • Internship and Residency
  • Interprofessional Relations
  • Interviews as Topic
  • Male
  • Medical Staff, Hospital
  • Mental Competency
  • Middle Aged
  • Physician-Patient Relations
  • Prospective Studies
  • Referral and Consultation*