title: Community hospital ethics consultation: evaluation and comparison with a university hospital service.
abstract: BACKGROUND
  Ethics consultants may improve patient care by responding to physician requests for assistance with problems they identify as ethical issues.
  
  
  OBJECTIVE
  To examine three aspects of ethics consultation: the clinical questions asked; the helpfulness of the consultation to requesting physicians; and the differences between consultations performed at a community teaching hospital and those performed at a university hospital.
  
  
  METHODS
  A community teaching hospital and a university teaching hospital.
  
  
  METHODS
  Physicians who formally requested ethics consultations in both hospitals and the patients for whom they requested them.
  
  
  METHODS
  Over 2 years (January 1, 1988, to December 31, 1989), we prospectively evaluated a newly established clinical ethics consultation service in a community teaching hospital using confidentially completed, pretested, structured questionnaires, and compared our data with previously reported university hospital data.
  
  
  RESULTS
  During the 2-year study, 104 consultation requests were received from 68 physicians in eight departments. Requesters most often requested consultation about deciding to forego life-sustaining treatment (74%), resolving disagreements (46%), and assessing patient competence (30%). Requesters found the consultation "very helpful" or "helpful" in one or more aspects of patient care in 86% of cases, or in one or more aspects of physician education in 86% of cases. These data are similar to university hospital data.
authors.affiliation: Center for Clinical Ethics, Lutheran General Hospital, Park Ridge, Illinois 60068.
authors.forename: J
authors.initials: J
authors.lastname: La Puma
authors.forename: C B
authors.initials: CB
authors.lastname: Stocking
authors.forename: C M
authors.initials: CM
authors.lastname: Darling
authors.forename: M
authors.initials: M
authors.lastname: Siegler
mesh_terms: D000293:Adolescent; D000328:Adult; D016223:Advance Directives; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D026688:Bioethical Issues; D002648:Child; D002675:Child, Preschool; D026822:Ethicists; D033061:Ethics Consultation; D026690:Ethics, Clinical; D004992:Ethics, Medical; D005069:Evaluation Studies as Topic; D005260:Female; D006764:Hospitals, Community / Q000592:standards*; D006785:Hospitals, University / Q000592:standards*; D006801:Humans; D007396:Internship and Residency; D007400:Interprofessional Relations; D007407:Interviews as Topic; D008297:Male; D008505:Medical Staff, Hospital; D016743:Mental Competency; D008875:Middle Aged; D010817:Physician-Patient Relations; D011446:Prospective Studies; D012017:Referral and Consultation