Technical Considerations for Implementation of Tele-Ethics Consultation in the Intensive Care Unit

Robust ethics consultation services cannot be sustained by all hospitals; consultative service from a high-volume center via teleconferencing is an attractive alternative. This pilot study was conceived to explore the feasibility and understand the practical implications of offering such a service.

High-definition videoconferencing was used to provide real-time interaction between the rounding clinicians and a remote clinical ethicist. Data collection included: (1) evaluation of the hardware and software required for teleconferencing, and (2) comparison of ethics trigger counts between the remote and on-site ethicist during rounds.

Issues with audio represented the majority of technical problems. Once technical difficulties were addressed, the on-site ethicist's count of "triggers" was not statistically different from the count of the remote ethicist.

Remote clinical ethics rounding is feasible when the equipment is optimized. Remote ethicists can identify similar numbers of "triggers" for possible ethical issues when compared to on-site ethicist numbers.