title: Evaluation of a medical ethics consultation service: opinions of patients and health care providers.
abstract: OBJECTIVE
  To study the perceived effectiveness of bioethics consultation as evaluated by both professional staff and patients and their families.
  
  
  METHODS
  An evaluation questionnaire was forwarded to physicians, nurses and patients or family members who were associated with 20 sequential cases referred for ethics consultation during a 2-year period. Respondents were asked to rate the consult as very helpful, somewhat helpful, or not helpful concerning a variety of issues related to the care of the patients. Responses were reviewed for agreement or disagreement between the three sample groups.
  
  
  RESULTS
  Ninety-six percent of physicians and 95% of nurses sampled felt that the consult was helpful, compared with only 65% of the patient/family responses. Lack of communication between patients and staff was cited as a problem in all cases in which the consult was deemed unhelpful by patients and family.
  
  
  CONCLUSIONS
  Patients or family members and professional staff have different perceptions regarding the value of bioethics consultation. When asked for comments, patients/family members cite lack of communication with professional staff as their primary reason for responding negatively. Earlier mobilization of consultative staff, rigorous training of consultants in techniques of conflict resolution, and education of primary caregivers regarding recognition of communication problems may serve to narrow this perceptual divergence.
authors.affiliation: Division of Clinical Ethics, Department of Medicine, New York Medical College, Vallalla 10595, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: McClung
authors.forename: R S
authors.initials: RS
authors.lastname: Kamer
authors.forename: M
authors.initials: M
authors.lastname: DeLuca
authors.forename: H J
authors.initials: HJ
authors.lastname: Barber
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001290:Attitude; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D003142:Communication; D003220:Conflict, Psychological; D004992:Ethics, Medical; D005069:Evaluation Studies as Topic; D005190:Family; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009726:Nurses; D010820:Physicians; D011368:Professional-Family Relations; D011369:Professional-Patient Relations; D012017:Referral and Consultation; D012189:Retrospective Studies; D011795:Surveys and Questionnaires