Two Approaches of 'Proactive Consultation': Towards Well-Functioning Clinical Ethics Consultation

Area of Science:

• Medical Ethics
• Healthcare Management
• Clinical Psychology

Background:

• Growing global demand for clinical ethics consultation services (CECS) to manage ethical challenges and moral distress in clinical settings.
• Despite increased adoption in Japanese hospitals over the last decade, many CECS are underutilized and ineffective due to a low volume of consultations.

Purpose of the Study:

• To propose and detail two proactive methods for enhancing the effectiveness of clinical ethics consultation services.
• To shift the initiation of consultations from healthcare providers (consultees) to the ethics consultation teams themselves.
• To explore the impact, value, and critical success factors of proactive ethics consultation.

Main Methods:

• Introduction of two proactive ethics consultation strategies: inter-professional ethics rounds and patient note reviews.
• Detailed explanation of these methods, supported by scenarios derived from actual clinical cases.
• Examination of critical success factors, including team attitude, positioning, and competency.

Main Results:

• Proactive methods can transform CECS into 'well-functioning' services by changing the consultation starting point.
• These approaches aim to increase consultation frequency and engagement.
• Identified key factors for successful implementation of proactive ethics consultation.

Conclusions:

• The proposed proactive ethics consultation methods offer valuable insights for improving CECS.
• These strategies can enhance the functionality and impact of ethics services in clinical environments.
• The study encourages further academic discussion on the definition and achievement of 'well-functioning' CECS.