Ethics Consultation in U.S. Hospitals: A National Follow-Up Study

Area of Science:

• Medical Ethics
• Healthcare Management
• Hospital Administration

Background:

• A 1999-2000 study highlighted concerns regarding U.S. hospital ethics consultation (EC) practices.
• This prior study prompted significant efforts to improve EC services nationwide.

Purpose of the Study:

• To assess changes in U.S. hospital EC practices since the 2000 national study.
• To identify trends in the utilization, staffing, and evaluation of EC services.

Main Methods:

• A 105-item survey was administered to "best informants" in a stratified random sample of 600 U.S. general hospitals.
• The study focused on 16 items from the 1999-2000 survey to enable direct comparison.

Main Results:

• The estimated annual number of case consultations increased by 94% to 68,000.
• Median consults per hospital remained stable, but increased for larger facilities (400+ beds).
• Practitioner education levels were unchanged; formal EC evaluation decreased from 28.0% to 19.1%.

Conclusions:

• While EC case volume has grown, formal evaluation and quality assurance have declined.
• Disparities in EC services between large teaching and small non-teaching hospitals have widened.
• Future improvement initiatives should prioritize hospitals with identified unmet EC needs.