Pediatric Clinical Ethics Consultations at an Academic Medical Center: Does One Size Fit All?

Hellyer, Joan Henriksen; Schiltz, Brenda; Moon, Wendy; Grafelman, Michelle; Yoshimatsu, K; Swetz, Keith M.

doi:10.1080/15265161.2015.1023115

Cited by 13 publications

(3 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a Swiss study of 95 cases, ICU and rehabilitation were the most prominent departments 13. Other large case sets are from a hospital primarily treating oncology patients10 or report in terms of ‘primary diagnosis’9 or ‘place of consult’11 rather than referring department.…”

Section: Discussionmentioning

confidence: 99%

“…The appropriate way to classify paediatric clinical ethics cases is a contested issue in the existing literature 9 16. In the absence of a standardised typology for paediatric clinical ethics cases, our analysis used a paediatric-specific working typology for ethics consultations.…”

Section: Typologymentioning

confidence: 99%

“…Recently, several paediatric-specific studies have also been published, primarily from the US context 9–14. Three themes that emerge from existing studies are the large proportion of case referrals for children less than a year old,7–9 13 14 the diversity of case typologies used,9 10 15 16 and the way in which the case sets vary depending on the nature and focus of the hospital 10 17…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

What kinds of cases do paediatricians refer to clinical ethics? Insights from 184 case referrals at an Australian paediatric hospital

McDougall

Notini

2016

J Med Ethics

View full text Add to dashboard Cite

Clinical ethics has been developing in paediatric healthcare for several decades. However, information about how paediatricians use clinical ethics case consultation services is extremely limited. In this project, we analysed a large set of case records from the clinical ethics service of one paediatric hospital in Australia. We applied a paediatric-specific typology to the case referrals, based on the triadic doctor-patient-parent relationship. We reviewed the 184 cases referred to the service in the period 2005-2014, noting features including the type of case, the referring department(s) and the patient's age at referral. The two most common types of referral involved clinician uncertainty about the appropriate care pathway for the child (26% of total referrals) and situations where the child's parents disagreed with the doctors' recommendations for the child's care (22% of total referrals). Referrals came from 28 different departments. Cancer, cardiology/cardiac surgery and general medicine referred the highest numbers of cases. The most common patient age groups were children under 1, and 14-15 years old. For three controversial areas of paediatric healthcare, clinicians had initiated processes of routine review of cases by the clinical ethics service. These insights into the way in which one very active paediatric clinical ethics service is used further our understanding of the work of paediatric clinical ethics, particularly the kinds of ethically challenging cases that paediatricians view as appropriate to refer for clinical ethics support.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Typologymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

What kinds of cases do paediatricians refer to clinical ethics? Insights from 184 case referrals at an Australian paediatric hospital

McDougall

Notini

2016

J Med Ethics

View full text Add to dashboard Cite

show abstract

Healthcare Ethics Consultation as Public Philosophy

Fuller¹,

Navin²

2022

A Companion to Public Philosophy

View full text Add to dashboard Cite

Content review of pediatric ethics consultations at a cancer center

Winter

Friedman

McCabe

et al. 2019

Pediatric Blood & Cancer

View full text Add to dashboard Cite

Background/objectives Ethical challenges in pediatric oncology arise at every stage of illness. However, there are sparse data on the content of and reason for ethics consultations in the field. We sought to evaluate the content and characteristics of ethics consultations in pediatric patients at a cancer center. Design/methods We retrospectively identified ethics consultations performed for patients diagnosed with cancer at ≤21 years of age who were treated in the Department of Pediatrics from 2007 to 2017. Using an established coding schema, two independent reviewers analyzed the content of ethics consultation notes and identified core ethical issues and relevant contextual issues. Demographic, clinical, and consultation‐specific data were also collected. Results Thirty‐five consultations were performed for 32 unique patients. The most commonly identified ethical issues were obligation to provide nonbeneficial treatment (29%) and resuscitation preferences (26%). Communication conflicts were the most commonly identified contextual issue (40%). There were two themes that emerged repeatedly but were not a part of the original coding schema—four consultations (11%) that involved physicians questioning their obligation to provide potentially toxic treatment in the setting of poor patient/parent compliance, and two consultations (6%) related to complex risk‐benefit analysis in the setting of an invasive procedure with uncertain benefit. Conclusions Pediatric ethics consultations are infrequent at this specialty cancer hospital. Ethical issues focused on treatment and end‐of‐life care and included a diversity of communication conflicts.

show abstract

Pediatric Clinical Ethics Consultations at an Academic Medical Center: Does One Size Fit All?

Cited by 13 publications

References 3 publications

What kinds of cases do paediatricians refer to clinical ethics? Insights from 184 case referrals at an Australian paediatric hospital

What kinds of cases do paediatricians refer to clinical ethics? Insights from 184 case referrals at an Australian paediatric hospital

Healthcare Ethics Consultation as Public Philosophy

Content review of pediatric ethics consultations at a cancer center

Contact Info

Product

Resources

About