Cambridge Quarterly of Healthcare Ethics



Ethics Committees at Work

Dissatisfaction with Ethics Consultations: The Anna Karenina Principle


LAWRENCE J.  SCHNEIDERMAN  a1 , TODD  GILMER  a2 , HOLLY D.  TEETZEL  a3 , DANIEL O.  DUGAN  a4 , PAULA  GOODMAN-CREWS  a5 and FELICIA  COHN  a6
a1 Departments of Family and Preventive Medicine and Medicine, School of Medicine, University of California, San Diego
a2 Department of Family and Preventive Medicine at the University of California, San Diego
a3 Department of Family and Preventive Medicine at the University of California, San Diego
a4 Emanuel Medical Center, Turlock, California, and Swedish Covenant Hospital, Chicago, Illinois
a5 Kaiser Permanente San Diego
a6 University of California, Irvine School of Medicine

Article author query
schneiderman lj   [PubMed][Google Scholar] 
gilmer t   [PubMed][Google Scholar] 
teetzel hd   [PubMed][Google Scholar] 
dugan do   [PubMed][Google Scholar] 
goodman-crews p   [PubMed][Google Scholar] 
cohn f   [PubMed][Google Scholar] 

In a previously published multicenter, prospective, randomized, controlled trial of more than 500 intensive care unit patients involved in conflicts over treatment decisions, ethics consultations were found to be helpful in resolving the conflicts and reducing nonbeneficial treatments. The intervention received favorable reviews by 80% of patient surrogates and more than 90% of physicians and nurses. Nevertheless, several participants in the ethics consultation process expressed dissatisfactions with the intervention. In this paper, we report our efforts to determine the factors associated with these negative responses in hopes that we might provide insights of future use to ethics consultants. a



Footnotes

a We gratefully acknowledge the contributions of Jeffrey Blustein, Kathleen B. Briggs, Ronald Cranford, Glen I. Komatsu, and Ernle W.D. Young to the original randomized controlled trial phase of this research. Grant support came from the Agency for Healthcare Research and Quality, 1 R01 HS10251.



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