Report of 255 clinical ethics consultations and review of the literature

Keith M. Swetz, Mary Eliot Crowley, C. Christopher Hook, Paul Mueller

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

OBJECTIVE: To review clinical ethics consultations at a tertiary care academic medical center. METHODS: We retrospectively reviewed all ethics consultations (and associated patient medical records) conducted at the Mayo Clinic in Rochester, Minn, between April 6, 1995, and December 31, 2005. RESULTS: Of the 255 consultations, 101 (40%) reviewed intensive care unit care, 103 (40%) involved patients who died during hospitalization, and 174 (68%) were requested by physicians. The most common primary diagnoess of the patients involved were malignancy (18%, n=47), neurologic disease (18%, n=47), and cardiovascular disease (17%, n=43). Most cases involved multiple issues: patient competency and decision-making capacity (82%, n=208), staff member disagreement with care plans (76%, n=195), end-of-the and quality-of-life issues (60%, n=154), and goals of care and futility (54%, n=138). Witholding or withdrawilng measures was the focus of 182 (82%) of the consultations. We also identified previously published reports of ethics consultations and compared the findings of those reports with ours. CONCLUSIONS: Despite advances in medicine, the nature of ethical dilemmas remains relatively unchanged. Issues of communication, family conflict, and futility continue to give rise to ethical quandaries.

Original languageEnglish (US)
Pages (from-to)686-691
Number of pages6
JournalMayo Clinic Proceedings
Volume82
Issue number6
DOIs
StatePublished - 2007

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Ethics Consultation
Clinical Ethics
Medical Futility
Referral and Consultation
Patient Care Planning
Family Conflict
Tertiary Healthcare
Nervous System Diseases
Medical Records
Intensive Care Units
Decision Making
Hospitalization
Cardiovascular Diseases
Communication
Quality of Life
Medicine
Physicians
Neoplasms

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Report of 255 clinical ethics consultations and review of the literature. / Swetz, Keith M.; Crowley, Mary Eliot; Hook, C. Christopher; Mueller, Paul.

In: Mayo Clinic Proceedings, Vol. 82, No. 6, 2007, p. 686-691.

Research output: Contribution to journalArticle

Swetz, Keith M. ; Crowley, Mary Eliot ; Hook, C. Christopher ; Mueller, Paul. / Report of 255 clinical ethics consultations and review of the literature. In: Mayo Clinic Proceedings. 2007 ; Vol. 82, No. 6. pp. 686-691.
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