Effectiveness of an ethics consultation service.

BACKGROUND

Ethics consultation is a relatively new service in clinical medicine. Most such services have been developed in departments of internal medicine. Few studies have evaluated the results of such consultations, and none have examined whether a family practice perspective enhances the consultation process.

METHODS

An ethics consultation service was established in the Department of Family Medicine at Loma Linda University School of Medicine in 1990. Data were collected from the consultations performed during the first year. A questionnaire was sent to the attending physicians for their evaluation of the service.

RESULTS

Ethics consultations were provided to the health care teams of 46 patients in five clinical departments. The attending physicians found the consultations to be important in clarifying ethical issues, educating the team, increasing confidence in decisions, and in patient management in more than 90% of the cases; however, the consultations resulted in significant changes in patient management only 36% of the time.

CONCLUSIONS

It is feasible to establish an ethics consultation service within a department of family medicine in a university hospital and to provide consultations to physicians in other specialties.