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Abstract
Context: Ethics consultation in the US is widely used and reported in the literature, but multi-site comparison studies and data sharing across institutions are largely unknown or at least unreported. Objective: To better understand the different methods used by ethics services to record, taxonomize, analyze, and utilize data regarding their case consultations. Design: a 37-item questionnaire surveying persons who are "familiar with their ethics consultation database". Participants: A convenience sample of ethics service personnel recruited from several e-mail lists known to have ethics consultants among their subscribers. Results: A total of 53 unique surveys were completed. There was wide variety in institution's bed-size, consult volume, and ethics staffing among respondents. Recording practices for cases were similarly varied, with some institutions merely keeping paper documents with no analysis, others used spreadsheets with rudimentary analysis, and high-volume services employing specific programs or electronic medical record functions to provide a more robust analysis of various case features. The data recorded followed ASBH guidelines to varying degrees. Respondents reported a general desire for some standardization of recording methods and data types/inputs, which would be necessary before significant data sharing across institutions can be feasible or valuable.
Introduction
Healthcare ethics consultation is a service available in various healthcare settings that "seek[s] to resolve uncertainty or conflict regarding valueladen concerns that emerge in health care" such as patient rights, surrogate decision-making, and issues at the beginning and end of life.1 Ethics consultation in hospitals has been practiced for over five decades.2 Hospital ethics committees may perform a consultation function as part of their commitment to patient safety standards required by the Joint Commission on Accreditation of Healthcare Organizations that relate to the rights and responsibilities of the individual, to provide an ethical infrastructure to respect patient rights, values, beliefs, preferences, and decisions (RI.01.01.01 and RI.01.02.01).3 Such committees also typically provide policy development, organizational support, and an educational resource for the hospital regarding various ethical questions.4 At larger health-care institutions and systems, a single consultant or small team is more likely to take responsibility for addressing most ethics consultation requests.
Previous empirical studies of ethics programs at multiple locations, notably the 2007 study by Ellen Fox, Sarah Myers, and Robert Pearlman, have demonstrated two important findings. First, there has historically...
