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Related Experiment Videos

Ethics consultation in the intensive care unit.

Lawrence J Schneiderman1

  • 1Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California 92093-0622, USA. ljs@ucsd.edu

Current Opinion in Critical Care
|November 18, 2005
PubMed
Summary

Ethics consultations in intensive care units (ICUs) help resolve end-of-life treatment conflicts. Recent trials show these consultations reduce hospital days, costs, and ventilator use for non-surviving patients.

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Area of Science:

  • Medical Ethics
  • Intensive Care Medicine
  • Health Services Research

Background:

  • Ethical principles guide complex medical treatment decisions, especially end-of-life care in ICUs.
  • Previous evidence supporting ethics consultations was limited.
  • Recent research provides stronger data on the impact of ethics consultations.

Purpose of the Study:

  • To review recent literature on the role of ethics consultations in intensive care settings.
  • To evaluate the effectiveness of ethics consultations in resolving treatment conflicts.

Main Methods:

  • Review of recent medical literature.
  • Analysis of prospective randomized controlled trials (single-site and multi-site) of ethics consultations in ICUs.
  • Assessment of patient outcomes and stakeholder reception.

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Main Results:

  • Ethics consultations significantly reduced hospital days, hospital costs, and ventilator days in patients who did not survive to hospital discharge.
  • Consultations were well-received by all parties involved.
  • Demonstrated effectiveness in addressing conflicts regarding life-sustaining treatment limitations.

Conclusions:

  • Ethics consultations appear effective in resolving conflicts that may lead to prolonged, non-beneficial treatments at the end of life.
  • Further research is needed to determine the benefits in other settings and establish optimal scope.
  • The success of these interventions may depend on the skill and experience of the consultants.