Residents' access to ethics consultations: knowledge, use, and perceptions.
OBJECTIVE
To examine residents' levels of awareness, use, and perceptions of the ethics consultation service at Loyola University Medical Center, a large Midwestern academic teaching hospital.


METHODS
In 2001-2002, the authors conducted a cross-sectional survey and semistructured interviews about knowledge and use of the ethics consultation service among all 229 internal medicine, surgery, anesthesiology, pediatrics, and medicine-pediatrics residents. Chi-square and t tests were used to compare categorical and continuous variables.


RESULTS
In all, 135 (59%) of the residents responded, and of these 22 (16%) completed an interview. Most survey respondents (76%) reported awareness of the ethics consultation service, although only 28 (21%) indicated they knew how to request one. Most respondents (89%) had never personally requested an ethics consultation. Thirteen residents (10%) had wanted to call an ethics consultation, but decided not to request one. Residents reported barriers to requesting an ethics consultation were the attending physician's opposition (46%), lack of awareness of the ethics consultation service (15%), and negative perceptions of ethics consultations (15%).


CONCLUSIONS
Several barriers hindered residents' use of ethics consultation services. Health care institutions should systematically educate employees about the availability and use of ethics consultation services. Institutions should establish mechanisms to give health care professionals in subordinate roles within the medical hierarchy a safe way to access and use the service.
Gacki-Smith
Jessica
J
Health Policy and Administration, School of Public Health, University of Illinois at Chicago, USA.
Gordon
Elisa J
EJ
D000328:Adult; D003430:Cross-Sectional Studies; D033061:Ethics Consultation; D004992:Ethics, Medical; D005260:Female; D006801:Humans; D007087:Illinois; D007396:Internship and Residency; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000523:psychology*; D011795:Surveys and Questionnaires