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Why doctors use or do not use ethics consultation.

J P Orlowski1, S Hein, J A Christensen

  • 1University Community Hospital, 3100 East Fletcher Avenue, Tampa, FL 33613, USA. jameso@mail.uch.org

Journal of Medical Ethics
|September 1, 2006
PubMed
Summary
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Doctors who believe in shared decision-making use ethics consultation. Those who do not use it feel it is their sole responsibility to resolve patient issues and believe they are already proficient in ethics.

Area of Science:

  • Medical Ethics
  • Healthcare Management
  • Clinical Decision-Making

Background:

  • Physician utilization of ethics consultation services varies significantly.
  • Some physicians regularly engage these services, while others exhibit reluctance.

Purpose of the Study:

  • To identify key factors influencing physicians' decisions to request or forgo ethics consultation.
  • To understand the physician perspective on the utility and accessibility of ethics consultation.

Main Methods:

  • A survey questionnaire was administered to physicians at University Community Hospital, Tampa, Florida.
  • Responses were analyzed using Likert scales, Wilcoxon tests, chi-squared tests, and logistic regression analysis.

Main Results:

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  • A 65% response rate (121/186) was achieved, with no demographic differences between user and non-user groups.
  • Physicians who used ethics consultation valued shared decision-making and diverse viewpoints, while non-users felt a personal responsibility for issue resolution.
  • Surgeons who believed consultants "cannot grasp the full picture from the outside" were significantly less likely to use ethics consultation (p=0.0004).

Conclusions:

  • Physician adoption of ethics consultation correlates with a belief in shared decision-making.
  • Perceived personal responsibility and self-assessed ethical proficiency influence non-utilization of ethics consultation services.