La Puma J, Stocking C B, Darling C M, Siegler M
Center for Clinical Ethics, Lutheran General Hospital, Park Ridge, Illinois 60068.
Am J Med. 1992 Apr;92(4):346-51. doi: 10.1016/0002-9343(92)90262-a.
Ethics consultants may improve patient care by responding to physician requests for assistance with problems they identify as ethical issues.
To examine three aspects of ethics consultation: the clinical questions asked; the helpfulness of the consultation to requesting physicians; and the differences between consultations performed at a community teaching hospital and those performed at a university hospital.
A community teaching hospital and a university teaching hospital.
Physicians who formally requested ethics consultations in both hospitals and the patients for whom they requested them.
Over 2 years (January 1, 1988, to December 31, 1989), we prospectively evaluated a newly established clinical ethics consultation service in a community teaching hospital using confidentially completed, pretested, structured questionnaires, and compared our data with previously reported university hospital data.
During the 2-year study, 104 consultation requests were received from 68 physicians in eight departments. Requesters most often requested consultation about deciding to forego life-sustaining treatment (74%), resolving disagreements (46%), and assessing patient competence (30%). Requesters found the consultation "very helpful" or "helpful" in one or more aspects of patient care in 86% of cases, or in one or more aspects of physician education in 86% of cases. These data are similar to university hospital data.
伦理顾问可通过回应医生就其认定为伦理问题的难题提出的求助请求，来改善患者护理。
研究伦理会诊的三个方面：所提出的临床问题；会诊对求助医生的帮助程度；社区教学医院进行的会诊与大学医院进行的会诊之间的差异。
一家社区教学医院和一家大学教学医院。
在两家医院正式请求进行伦理会诊的医生及其所请求会诊的患者。
在两年时间里（1988年1月1日至1989年12月31日），我们使用经保密填写、预先测试的结构化问卷，对一家社区教学医院新设立的临床伦理会诊服务进行了前瞻性评估，并将我们的数据与先前报告的大学医院数据进行了比较。
在为期两年的研究中，我们收到了来自八个科室68位医生的104次会诊请求。请求者最常请求会诊的问题是决定放弃维持生命的治疗（74%）、解决分歧（46%）以及评估患者的行为能力（30%）。在86%的病例中，请求者发现会诊在患者护理的一个或多个方面“非常有帮助”或“有帮助”，在86%的病例中，在医生教育的一个或多个方面也是如此。这些数据与大学医院的数据相似。
