title: Ethics rounds do not improve the handling of ethical issues by psychiatric staff.
abstract: BACKGROUND
  One way to support healthcare staff in handling ethically difficult situations is through ethics rounds that consist of discussions based on clinical cases and are moderated by an ethicist. Previous research indicates that the handling of ethically difficult situations in the workplace might have changed after ethics rounds. This, in turn, would mean that the "ethical climate", i.e. perceptions of how ethical issues are handled, would have changed.
  
  
  OBJECTIVE
  To investigate whether ethics rounds could improve the ethical climate perceived by staff working in psychiatry outpatient clinics.
  
  
  METHODS
  In this quasi-experimental study, six inter-professional ethics rounds led by a philosopher/ethicist were conducted at two psychiatry outpatient clinics. Changes in ethical climate were measured at these clinics as well as at two control clinics at baseline and after the intervention period using the instrument Hospital Ethical Climate Survey.
  
  
  RESULTS
  Within-groups comparisons of median sum scores of ethical climate showed that no statistically significant differences were found in the intervention group before or after the intervention period. The median sum scores for ethical climate were significantly higher, both at baseline and after the intervention period (P ≤ 0.001; P = 0.046), in the intervention group.
  
  
  CONCLUSIONS
  Ethics rounds in psychiatric outpatient clinics did not result in significant changes in ethical climate. Outcomes of ethics rounds might, to a higher degree, be directed towards patient-related outcomes rather than towards the staff's working environment, as the questions brought up for discussion during the ethics rounds concerned patient-related issues.
authors.affiliation: Marit Silén, Ph.D., R.N., Post doc., Centre for Research Ethics & Bioethics, Uppsala University , Box 564, SE-751 22 Uppsala , Sweden.
authors.forename: Marit
authors.initials: M
authors.lastname: Silén
authors.forename: Kristina
authors.initials: K
authors.lastname: Haglund
authors.forename: Mats G
authors.initials: MG
authors.lastname: Hansson
authors.forename: Mia
authors.initials: M
authors.lastname: Ramklint
mesh_terms: D001291:Attitude of Health Personnel; D003155:Community Mental Health Centers / Q000941:ethics*; D003299:Cooperative Behavior; D033061:Ethics Consultation; D004992:Ethics, Medical; D006801:Humans; D033183:Interdisciplinary Communication; D001523:Mental Disorders / Q000628:therapy*; D010348:Patient Care Team / Q000941:ethics*; D016896:Treatment Outcome
keywords: Attitude of health personnel; CommunityMentalHealthCenters; Ethics, Clinical