The ‘Big Five’ in 100 Clinical Ethics Consultation Cases. Evaluating three years of ethics support in the Basel University Hospitals

Reiter-Theil, Stella and Schürmann, Jan. (2016) The ‘Big Five’ in 100 Clinical Ethics Consultation Cases. Evaluating three years of ethics support in the Basel University Hospitals. Bioethica Forum, 9 (2). pp. 12-22.

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Official URL: http://edoc.unibas.ch/52804/

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The study aims at shedding light into the practice of
Clinical Ethics Consultation (EC) thereby making a contribution to bet
ter understanding its triggers, contents and outcomes. It was carried out
in 2 (out of 3) local University Hospitals.
Material and method:
100 full ECs (50 ECs conducted at the somatic/
USB, 50 at the Psychiatric University Hospital/UPK) over 3 years were
analysed on the basis of its rich and highly standardised documentation.
Overall, the majority of all ECs (84%) feature ethical issues
referring to at least one of the following 5 topics: coercion (28%), care
management (24%), treatment-plan evaluation (17%), end-of-life care
(16%), or pregnancy / assisted reproduction (12%).
In USB ECs, the top 3 main ethical issues concern end-of-life care (28%),
pregnancy / assisted reproduction (22%), and coercion (20%), followed
by treatment limitation (8%), and care management (6%). The single
most significant main ethical issue in UPK ECs is coercion (34%), fol
lowed by care management and treatment-plan evaluation (both 20%).
The prevalence of end-of-life issues in somatic health care
is in line with previous research, while the evidence for coercion as a
major topic in ECs in general is new. Comparable studies are hardly
available from other European centres, and the existing North American
papers do not display a prevalence of this concern.
The thematic shift to a double focus on end-of-life deci
coercion and the “big five” themes revealed altogether stim-
ulate the catalogue of clinical ethics education, both for ethics consul
tants and health care professions.
Faculties and Departments:03 Faculty of Medicine > Departement Public Health > Ehemalige Einheiten Public Health > Medizin- und Gesundheitsethik (Reiter-Theil)
08 Cross-disciplinary Subjects > Ethik > Institut für Bio- und Medizinethik > Bio- und Medizinethik (Elger)
03 Faculty of Medicine > Departement Public Health > Ethik in der Medizin > Bio- und Medizinethik (Elger)
UniBasel Contributors:Reiter-Theil, Stella and Schürmann, Jan
Item Type:Article, refereed
Article Subtype:Research Article
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:27 Oct 2017 15:05
Deposited On:27 Oct 2017 15:05

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