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Frequency of Perceived Conflict between Families and Clinicians at Time of Clinical Ethics Consultation in

Aleksandra E Olszewski1, Chuan Zhou2,3, Jiana Ugale4

  • 1Division of Critical Care Medicine, Department of Pediatrics, Lurie Children's Hospital and Northwestern University, Chicago, Illinois, USA.

AJOB Empirical Bioethics
|September 27, 2023
PubMed

Insights

Conflict between clinicians and families is common during pediatric ethics consultations, affecting nearly half of cases. Specific topics like informed consent and life support discussions were linked to higher conflict rates.

Area of Science:

  • Pediatric Ethics
  • Clinical Decision-Making
  • Healthcare Conflict Resolution

Background:

  • The frequency and associated factors of conflict during pediatric clinical ethics consultation (CEC) are not well understood.
  • Conflict can impact the quality of care and family-physician relationships.

Purpose of the Study:

  • To determine the frequency of perceived conflict between clinicians and families during pediatric CEC.
  • To identify factors associated with the presence of such conflicts.

Main Methods:

  • Retrospective cohort study at a US tertiary pediatric hospital (2008-2019).
  • Analysis of a CEC database documenting clinician-family conflict.
  • Bivariable assessment of conflict association with patient demographics and consultation factors.

Main Results:

  • Perceived conflict was present in 44% of pediatric CECs.
  • Higher conflict rates were observed in consultations concerning informed consent (69%), cultural considerations (67%), benefit/harm assessment (58%), and life-sustaining treatment limitations (58%).
  • No significant associations were found between conflict and patient sociodemographic factors or other CEC characteristics.

Conclusions:

  • Clinician-family conflict is frequent in pediatric CEC, especially for specific ethical issues.
  • Further research is necessary to explore conflict types, causes, management strategies, and outcomes.
Abstract

Keywords:
Clinical ethics consultationconflictdisparitiesinequitiespediatrics

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