Bruce Courtenay R, Bibler Trevor M, Pena Adam M, Kusin Betsy
Center for Medical Ethics & Health Policy, Baylor College of Medicine, One Baylor Plaza, MS: BCM 420, Houston, TX, 77030, USA.
Houston Methodist Hospital System, Houston Methodist Hospital System Biomedical Ethics Program, Houston, TX, USA.
HEC Forum. 2016 Dec;28(4):283-299. doi: 10.1007/s10730-015-9300-x.
Despite the interpersonal nature of family meetings and the frequency in which they occur, the clinical ethics literature is devoid of any rich descriptions of what clinical ethicists should actually be doing during family meetings. Here, we propose a framework for describing and understanding "transitioning" facilitation skills based on a retrospective review of our internal documentation of 100 consecutive cases (June 01, 2013-December 31, 2014) wherein a clinical ethicist facilitated at least one family meeting. The internal documents were analyzed using qualitative methodologies, i.e., "codes", to identify emergent themes. We identified four different transitioning strategies clinical ethicists use to reach a meaningful resolution. These transitioning strategies serve as a jumping-off point for additional analyses, future research, evaluating clinical ethics consultation, and overall performance improvement of a consultation service.
尽管家庭会议具有人际互动的性质且频繁举行,但临床伦理文献中却缺乏对临床伦理学家在家庭会议期间实际应做之事的丰富描述。在此,我们基于对100例连续病例(2013年6月1日至2014年12月31日)的内部文档进行回顾性分析,提出了一个用于描述和理解“过渡”促进技巧的框架,在这些病例中,临床伦理学家至少促成了一次家庭会议。使用定性方法(即“编码”)对内部文档进行分析,以识别新出现的主题。我们确定了临床伦理学家用于达成有意义解决方案的四种不同过渡策略。这些过渡策略可作为进一步分析、未来研究、评估临床伦理咨询以及提高咨询服务整体绩效的起点。