Ethics consultation in United States hospitals: a national survey.
BACKGROUND
Although ethics consultation is commonplace in United States (U.S.) hospitals, descriptive data about this health service are lacking.


OBJECTIVE
To describe the prevalence, practitioners, and processes of ethics consultation in U.S. hospitals.


METHODS
A 56-item phone or questionnaire survey of the "best informant" within each hospital.


METHODS
Random sample of 600 U.S. general hospitals, stratified by bed size.


RESULTS
The response rate was 87.4%. Ethics consultation services (ECSs) were found in 81% of all general hospitals in the U.S., and in 100% of hospitals with more than 400 beds. The median number of consults performed by ECSs in the year prior to survey was 3. Most individuals performing ethics consultation were physicians (34%), nurses (31%), social workers (11%), or chaplains (10%). Only 41% had formal supervised training in ethics consultation. Consultation practices varied widely both within and between ECSs. For example, 65% of ECSs always made recommendations, whereas 6% never did. These findings highlight a need to clarify standards for ethics consultation practices.
Fox
Ellen
E
National Center for Ethics in Health Care, Department of Veterans Affairs, Washington, DC 20420, USA. ellen.fox@va.gov
Myers
Sarah
S
Pearlman
Robert A
RA
D028741:Ethics Committees, Clinical / Q000706:statistics & numerical data*; D033061:Ethics Consultation / Q000706:statistics & numerical data*; D006742:Hospital Bed Capacity; D006801:Humans; D028701:Patient Rights; D011795:Surveys and Questionnaires; D014481:United States