title: Ethics consultation on a gynecologic oncology service: an opportunity for physician education.
abstract: The purpose of this study is to understand the features of gynecologic oncology patients who receive ethics consults in order to identify areas for physician education and improve patient care. A review of ethics consults for gynecologic oncology patients from 1993 to 2008 was performed. Information on all gynecologic oncology patients treated during the study interval was also collected to define a base population for comparison. Forty-one consults were performed. Compared to the base population, a greater proportion of consult patients had pregnancy-related malignancies (7.9% vs. 0.8%, p < 0.0001) and were African American (33.3% vs. 10.9%, p < 0.0001). The most common clinical case types involved identifying levels of appropriate treatment. Support of the health care team and complex family dynamics were key underlying issues. Ethics consultation provides a substantial resource in identifying relevant issues experienced by gynecologic oncology patients upon which physician educational initiatives may be based.
authors.affiliation: Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, PO Box 301439, Unit 1362, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Schlumbrecht
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Gallagher
authors.forename: Charlotte C
authors.initials: CC
authors.lastname: Sun
authors.forename: Lois M
authors.initials: LM
authors.lastname: Ramondetta
authors.forename: Diane C
authors.initials: DC
authors.lastname: Bodurka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002983:Clinical Competence; D003695:Delivery of Health Care; D004502:Education, Medical, Continuing; D033061:Ethics Consultation / Q000592:standards*; D005260:Female; D005833:Genital Neoplasms, Female / Q000628:therapy*; D006801:Humans; D008495:Medical Oncology / Q000193:education*; D008875:Middle Aged; D010820:Physicians; D011247:Pregnancy; D011248:Pregnancy Complications; D055815:Young Adult