ethics rounds
Recently Published Documents


TOTAL DOCUMENTS

47
(FIVE YEARS 5)

H-INDEX

9
(FIVE YEARS 0)

PEDIATRICS ◽  
2021 ◽  
Author(s):  
Meaghann S. Weaver ◽  
Haavi Morreim ◽  
Lydia H. Pecker ◽  
Rachel O. Alade ◽  
David J. Alfandre

In this Ethics Rounds we present a conflict regarding discharge planning for a febrile infant in the emergency department. The physician believes discharge would be unsafe and would constitute a discharge against medical advice. The child’s mother believes her son has been through an already extensive and painful evaluation and would prefer to monitor her well-appearing son closely at home with a safety plan and a next-day outpatient visit. Commentators assess this case from the perspective of best interest, harm-benefit, conflict management, and nondiscriminatory care principles and prioritize a high-quality informed consent process. They characterize the formalization of discharge against medical advice as problematic. Pediatricians, a pediatric resident, ethicists, an attorney, and mediator provide a range of perspectives to inform ethically justifiable options and conflict resolution practices.


Animals ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 3010
Author(s):  
Anne Quain ◽  
Michael P. Ward ◽  
Siobhan Mullan

Advanced veterinary care (AVC) of companion animals may yield improved clinical outcomes, improved animal welfare, improved satisfaction of veterinary clients, improved satisfaction of veterinary team members, and increased practice profitability. However, it also raises ethical challenges. Yet, what counts as AVC is difficult to pinpoint due to continuing advancements. We discuss some of the challenges in defining advanced veterinary care (AVC), particularly in relation to a standard of care (SOC). We then review key ethical challenges associated with AVC that have been identified in the veterinary ethics literature, including poor quality of life, dysthanasia and caregiver burden, financial cost and accessibility of veterinary care, conflicts of interest, and the absence of ethical review for some patients undergoing AVC. We suggest some strategies to address these concerns, including prospective ethical review utilising ethical frameworks and decision-making tools, the setting of humane end points, the role of regulatory bodies in limiting acceptable procedures, and the normalisation of quality-of-life scoring. We also suggest a role for retrospective ethical review in the form of ethics rounds and clinical auditing. Our discussion reenforces the need for a spectrum of veterinary care for companion animals.


2021 ◽  
Vol 11 (4) ◽  
pp. 411-416
Author(s):  
Lulia A. Kana ◽  
Katherine J. Feder ◽  
Niki Matusko ◽  
Janice I. Firn

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Dagmar Schmitz ◽  
Dominik Groß ◽  
Roman Pauli

Abstract Background The theory and practice of ethics consultations (ECs) in health care are still characterized by many controversies, including, for example, the practice of giving recommendations. These controversies are complicated by an astonishing lack of evidence in the whole field. It is not clear how often a recommendation is issued in ethics consultations and when and why this step is taken. Especially in a facilitation model in which giving recommendations is optional, more data would be helpful to evaluate daily practice, ensure that this practice is in line with the overarching goals of this approach and support the development of standards. Methods We analyzed all consultations requested from an EC service working under a facilitation approach at a maximum-care university hospital in Germany over a period of more than 10 years. Our aim was to better understand why—and under what circumstances—some consultation requests result in a recommendation, whereas others can be sufficiently addressed solely by facilitated meetings. We especially wanted to know when and why clients felt the need for clear advice from the EC service while in other cases they did not. We compared ethics consultations in terms of the differences between cases with and without recommendations issued by the ethics consultants using χ2 difference tests and Welch’s t-test. Results A total of 243 ECs were carried out between September 2008 and December 2019. In approximately half of the cases, a recommendation was given. All recommendations were issued upon the request of clients. When physicians asked for an EC, the consultation was significantly more likely to result in a recommendation than when the EC was requested by any other party. ECs in cases on wards with ethics rounds resulted in comparably fewer recommendations than those in wards without ethics rounds. When interpersonal conflicts were part of the problem or relatives were present in the meeting, clients less frequently asked for a recommendation. Conclusion From the client’s point of view, there does not seem to be only one “right” way to provide ethics consultations, but rather several. While facilitated meetings are obviously appreciated by clients, there also seem to be situations in which a recommendation is desired (especially by physicians). Further empirical and theoretical research is needed to validate our single-center results and re-evaluate the role of recommendations in ethics consultations.


2019 ◽  

This collection is intended to be a starting point for a discussion on pediatric bioethics and a reference when reflecting on similar cases. https://shop.aap.org/pediatric-collections-ethics-rounds-a-casebook-in-pediatric-bioethics-paperback/


2018 ◽  
Vol 44 (12) ◽  
pp. 805-809
Author(s):  
Dagmar Schmitz ◽  
Dominik Groß ◽  
Charlotte Frierson ◽  
Gerrit A Schubert ◽  
Henna Schulze-Steinen ◽  
...  

Clinical ethics support (CES) services are experiencing a phase of flourishing and of growing recognition. At the same time, however, the expectations regarding the acceptance and the integration of traditional CES services into clinical processes are not met. Ethics rounds as an additional instrument or as an alternative to traditional clinical ethics support strategies might have the potential to address both deficits. By implementing ethics rounds, we were able to better address the needs of the clinical sections and to develop a more comprehensive account of ethics quality in our hospital, which covers the level of decisions and actions, and also the level of systems and processes and aspects of ethical leadership.


PEDIATRICS ◽  
2017 ◽  
Vol 140 (6) ◽  
pp. e20172370 ◽  
Author(s):  
Helen Lee ◽  
Peter Milgrom ◽  
Colleen E. Huebner ◽  
Philip Weinstein ◽  
Wylie Burke ◽  
...  

PEDIATRICS ◽  
2016 ◽  
Vol 138 (3) ◽  
pp. e20161398-e20161398 ◽  
Author(s):  
D. McKlindon ◽  
J. A. Jacobson ◽  
P. Nathanson ◽  
J. K. Walter ◽  
J. D. Lantos ◽  
...  
Keyword(s):  

PEDIATRICS ◽  
2015 ◽  
Vol 136 (5) ◽  
pp. e1487-e1488
Author(s):  
H. A. Rosenblum ◽  
C. D. Wagner
Keyword(s):  

PEDIATRICS ◽  
2015 ◽  
Vol 136 (5) ◽  
pp. e1487-e1487 ◽  
Author(s):  
M. K. Sugar ◽  
D. M. Goldberg

Sign in / Sign up

Export Citation Format

Share Document