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Rats were trained to eat free food from a dish, then trained to press a lever for similar food. The free food was then presented while subjects were pressing on several reinforcement schedules. Subjects continued to press for reinforcement when one or two presses were required for reinforcement, and ate little free food. When ten presses were required for reinforcement, rats preferred free food and pressed little or not at all. It was concluded that, when work demands are not too high, rats prefer earned food to free food.

Although ethics consultation is offered as a clinical service in most hospitals in the United States, few valid and practical tools are available to evaluate, ensure, and improve ethics consultation quality. The quality of ethics consultation is important because poor quality ethics consultation can result in ethically inappropriate outcomes for patients, other stakeholders, or the health care system. To promote accountability for the quality of ethics consultation, we developed the Ethics Consultation Quality Assessment Tool (ECQAT). ECQAT enables raters to assess the quality of ethics consultations based on the written record. Through rigorous development and preliminary testing, we identified key elements of a quality ethics consultation (ethics question, consultation-specific information, ethical analysis, and conclusions and/or recommendations), established scoring criteria, developed training guidelines, and designed a holistic assessment process. This article describes the development of the ECQAT, the resulting product, and recommended future testing and potential uses for the tool.

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