Ethics consultation in United States hospitals: a national survey

Am J Bioeth. 2007 Feb;7(2):13-25. doi: 10.1080/15265160601109085.


Context: Although ethics consultation is commonplace in United States (U.S.) hospitals, descriptive data about this health service are lacking.

Objective: To describe the prevalence, practitioners, and processes of ethics consultation in U.S. hospitals.

Design: A 56-item phone or questionnaire survey of the "best informant" within each hospital.

Participants: Random sample of 600 U.S. general hospitals, stratified by bed size.

Results: The response rate was 87.4%. Ethics consultation services (ECSs) were found in 81% of all general hospitals in the U.S., and in 100% of hospitals with more than 400 beds. The median number of consults performed by ECSs in the year prior to survey was 3. Most individuals performing ethics consultation were physicians (34%), nurses (31%), social workers (11%), or chaplains (10%). Only 41% had formal supervised training in ethics consultation. Consultation practices varied widely both within and between ECSs. For example, 65% of ECSs always made recommendations, whereas 6% never did. These findings highlight a need to clarify standards for ethics consultation practices.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Ethics Committees, Clinical / statistics & numerical data*
  • Ethics Consultation / statistics & numerical data*
  • Hospital Bed Capacity
  • Humans
  • Patient Rights*
  • Surveys and Questionnaires
  • United States