Participant | Primary reason for consult | Secondary reason for consult | Contextual issues |
1 | Other (visitor policy) | None | Other (parental/family coping) |
2 | DNR | None | Other (logistic delays) |
3 | Confidentiality | None | Cultural/ethnic/religious; physician attitude toward treatment |
4 | DNR | None | Other (logistic delays) |
5 | Futility | Withdrawal or withholding artificial N&H | Staff–family communication dispute/conflict; staff–patient communication dispute/conflict |
6 | Surrogate decision-making | Withdrawing of other life-sustaining therapy | Staff–family communication dispute/conflict |
7 | Withdrawal of other life-sustaining therapy | Transplant issues | Intrastaff communication dispute/conflict; quality of life; staff–family communication dispute/conflict |
8 | Other (visitor policy) | None | Other (parental/family coping) |
9 | DNR | Surrogate decision-making | Other (parental/family coping); staff–family communication dispute/conflict |
10 | Other (visitor policy) | None | Other (parental/family coping) |
11 | Refusal of recommended treatment | Discharge/placement | Staff–patient communication dispute/conflict |
12 | Refusal of recommended treatment | Isolated incapacitated patient | Staff–patient communication dispute/conflict |
13 | DNR | Isolated incapacitated patient | None |
14 | Surrogate decision-making | Advance directive | Staff–family communication dispute/conflict |
Adapted according to Nilson et al’s classification schema for ethics consultations.36
DNR, do not resuscitate; N&H, nutrition and hydration.