title: Case Complexity and Quality Attestation for Clinical Ethics Consultants.
abstract: A proposal by the American Society for Bioethics and Humanities (ASBH) to identify individuals who are qualified to perform ethics consultations neglects case complexity in candidates' portfolios. To protect patients and healthcare organizations, and to be fair to candidates, a minimum case complexity level must be clearly and publicly articulated. This proof-of-concept study supports the feasibility of assessing case complexity. Using text analytics, we developed a complexity scoring system, and retrospectively analyzed more than 500 ethics summaries of consults performed at an academic medical center during 2013. We demonstrate its use with seven case summaries that range in complexity from uncomplicated to very complicated. We encourage the ASBH to require a minimum level of case complexity, and recommend that attestation portfolios include several cases of moderate complexity and at least one very complex case.
authors.affiliation: Southern Illinois University School of Medicine, Department of Medical Humanities, 913 North Rutledge Street, Springfield, Illinois 62794 USA. bspielman@siumed.edu.
authors.forename: Bethany
authors.initials: B
authors.lastname: Spielman
authors.affiliation: Kaiser Permanente, Northern California, Program in Ethics, Oakland, California USA.
authors.forename: Jana
authors.initials: J
authors.lastname: Craig
authors.affiliation: Memorial Medical Center, Springfield, Illinois USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Gorka
authors.affiliation: University of Missouri, Saint Louis, Missouri, USA.
authors.forename: Keith
authors.initials: K
authors.lastname: Miller
mesh_terms: D000046:Academic Medical Centers; D026688:Bioethical Issues; D015986:Confounding Factors, Epidemiologic; D026822:Ethicists / Q000592:standards*; D033061:Ethics Consultation / Q000592:standards* / Q000639:trends; D006801:Humans; D011340:Problem Solving / Q000941:ethics*; D011361:Professional Competence / Q000592:standards*; D012189:Retrospective Studies; D014481:United States