Networking Ethics: A Survey of Bioethics Networks Across the U.S

Ethics Consultation in U.S. Hospitals: New Findings about Consultation Practices

BACKGROUND

While previous research has examined various aspects of ethics consultation (EC) in U.S. hospitals, certain EC practices have never been systematically studied.

METHODS

To address this gap, we surveyed a random stratified sample of 600 hospitals about aspects of EC that had not been previously explored.

RESULTS

New findings include: in 26.0% of hospitals, the EC service performs EC for more than one hospital; 72.4% of hospitals performed at least one non-case consultation; in 56% of hospitals, ECs are never requested by patients or families; 59.0% of case consultations involve conflict; the usual practice is to visit the patient in all formal EC cases in 32.5% of hospitals; 56.6% of hospitals do not include a formal meeting in most EC cases; 61.1% of hospitals do not routinely assess ethics consultants' competencies; and 31.6% of hospitals belong to a bioethics network. We estimate the total number of non-case consultations performed in U.S. hospitals to be approximately one half the number of case consultations; we estimate the total number of ECs performed in U.S. hospitals, including both case and non-case consultations, to be just over 100,000 per year.

CONCLUSIONS

These findings expand our current understanding of EC in U.S. hospitals, and raise several concerns that suggest a need for further research.

Creating a community driven bioethics network

Purpose

The South West Health Ethics Network (SWHEN) was created to bring together health care providers from a variety of health care settings across a geographical region. SWHEN’s mission was to connect health professionals who have an interest in ethical issues. SWHEN’s target participants are people with an interest in this field regardless of the individual’s capacity within an ethics profession. While other ethics networks exist, few of these expand beyond a narrow scope of ethics professionals (clinical ethicists). The preliminary vision in bringing together this group was to create a regional collaborative to educate, share lessons and begin to create a common approach to ethics issues in our region. Ethics networks increase collaboration and the exchange of resources, information and ideas among clinical ethicists. As a result, they address many of the ethical dilemmas faced in integrated care and facilitate the success of these systems in providing coordinated patient care. The paper aims to discuss these issues.

Design/methodology/approach

A Delphi consensus building approach was conducted to determine goals and priorities of the network.

Findings

Several priorities and counter priorities were discussed. In the end, the network was stifled by three major challenges: resource sharing, balance of network priorities and individual needs, and leadership.

Originality/value

While the journey to creating a sustainable network is long and complex, it is still worth the struggles. Network members remained connected through e-platforms, and the meetings have increased our region’s cohesiveness around ethics. We remain cautiously optimistic of SWHENs future and acknowledge that our initial plan may have shifted but our achievements are still meaningful and worthwhile.