Why Are There So Few Ethics Consults in Children’s Hospitals?

HEC Forum 30 (2):91-102 (2018)
  Copy   BIBTEX


In most children’s hospitals, there are very few ethics consultations, even though there are many ethically complex cases. We hypothesize that the reason for this may be that hospitals develop different mechanisms to address ethical issues and that many of these mechanisms are closer in spirit to the goals of the pioneers of clinical ethics than is the mechanism of a formal ethics consultation. To show how this is true, we first review the history of collaboration between philosophers and physicians about clinical dilemmas. Then, as a case-study, we describe the different venues that have developed at one children’s hospital to address ethical issues. At our hospital, there are nine different venues in which ethical issues are regularly and explicitly addressed. They are ethics committee meetings, Nursing Ethics Forum, ethics Brown Bag workshops, PICU ethics rounds, Grand Rounds, NICU Comprehensive Care Rounds, Palliative Care Team case conferences, multidisciplinary consults in Fetal Health Center, and ethics consultations. In our hospital, ethics consults account for only a tiny percentage of ethics discussions. We suspect that most hospitals have multiple and varied venues for ethics discussions. We hope this case study will stimulate research in other hospitals analyzing the various ways in which ethicists and ethics committees can build an ethical environment in hospitals. Such research might suggest that ethicists need to develop a different set of “core competencies” than the ones that are needed to do ethics consultations. Instead, they should focus on their skills in creating multiple “moral spaces” in which regular and ongoing discussion of ethical issues would take place. A successful ethicist would empower everyone in the hospital to speak up about the values that they believe are central to respectful, collaborative practice and patient care. Such a role is closer to what the first hospital philosophers set out to do than in the role of the typical hospital ethics consultant today.



    Upload a copy of this work     Papers currently archived: 80,022

External links

Setup an account with your affiliations in order to access resources via your University's proxy server

Through your library

Similar books and articles

The Status of Hospital Ethics Committees in Pennsylvania.Ellen L. Csikai - 1998 - Cambridge Quarterly of Healthcare Ethics 7 (1):104-107.
Hospital Ethics Committees in Poland.Marek Czarkowski, Katarzyna Kaczmarczyk & Beata Szymańska - 2015 - Science and Engineering Ethics 21 (6):1525-1535.
Invoking the Law in Ethics Consultation.Bethany Spielman - 1993 - Cambridge Quarterly of Healthcare Ethics 2 (4):457.


Added to PP

14 (#751,739)

6 months
1 (#478,086)

Historical graph of downloads
How can I increase my downloads?

Author Profiles

Brian Carter
University of Missouri, Kansas City
Jeremy Garrett
University of Missouri, Kansas City