TY - JOUR
T1 - Report of 255 clinical ethics consultations and review of the literature
AU - Swetz, Keith M.
AU - Crowley, Mary Eliot
AU - Hook, C. Christopher
AU - Mueller, Paul S.
PY - 2007/6
Y1 - 2007/6
N2 - 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.
AB - 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.
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U2 - 10.4065/82.6.686
DO - 10.4065/82.6.686
M3 - Article
C2 - 17550748
AN - SCOPUS:34249933637
SN - 0025-6196
VL - 82
SP - 686
EP - 691
JO - Mayo Clinic proceedings
JF - Mayo Clinic proceedings
IS - 6
ER -