Article Text
Abstract
Objective: The field of clinical ethics is relatively new and expanding. Best practices in clinical ethics against which one can benchmark performance have not been clearly articulated. The first step in developing benchmarks of clinical ethics services is to identify and understand current practices.
Design and setting: Using a retrospective case study approach, the structure, activities, and resources of nine clinical ethics services in a large metropolitan centre are described, compared, and contrasted.
Results: The data yielded a unique and detailed account of the nature and scope of clinical ethics services across a spectrum of facilities. General themes emerged in four areas—variability, visibility, accountability, and complexity. There was a high degree of variability in the structures, activities, and resources across the clinical ethics services. Increasing visibility was identified as a significant challenge within organisations and externally. Although each service had a formal system for maintaining accountability and measuring performance, differences in the type, frequency, and content of reporting impacted service delivery. One of the most salient findings was the complexity inherent in the provision of clinical ethics services, which requires of clinical ethicists a broad and varied skill set and knowledge base. Benchmarks including the average number of consults/ethicist per year and the hospital beds/ethicist ratio are presented.
Conclusion: The findings will be of interest to clinical ethicists locally, nationally, and internationally as they provide a preliminary framework from which further benchmarking measures and best practices in clinical ethics can be identified, developed, and evaluated.
- benchmarking
- clinical ethics
- descriptive study
- programme effectiveness
Statistics from Altmetric.com
Footnotes
-
Funding for this study was provided by the Joint Centre for Bioethics, University of Toronto.
-
Research Ethics Board approval to conduct this study was received from all participating sites (Baycrest Centre for Geriatric Care, Centre for Addiction and Mental Health, The Hospital for Sick Children, Mount Sinai Hospital, Centre for Clinical Ethics—St Michael’s Hospital, Sunnybrook and Women’s College Health Sciences Centre, Toronto Rehabilitation Institute, University Health Network, and Toronto East General Hospital) and the University of Toronto, Toronto, Ontario, Canada.
Read the full text or download the PDF:
Other content recommended for you
- Clinical bioethics integration, sustainability, and accountability: the Hub and Spokes Strategy
- Paediatric clinical ethics in Australia and New Zealand: a survey
- Development of clinical ethics services in the UK: a national survey
- What kinds of cases do paediatricians refer to clinical ethics? Insights from 184 case referrals at an Australian paediatric hospital
- Clinical ethicists’ perspectives on organisational ethics in healthcare organisations
- The need for a clinical ethics service and its goals in a community healthcare service centre: a survey
- Taking the burden off: a study of the quality of ethics consultation in the time of COVID-19
- How to read an ethics paper
- Ethics of fertility preservation for prepubertal children: should clinicians offer procedures where efficacy is largely unproven?
- Views regarding the training of ethics consultants: a survey of physicians caring for patients in ICU