When Do Pediatricians Call the Ethics Consultation Service? Impact of Clinical Experience and Formal Ethics Training

Abstract

Background: Previous research shows that pediatricians inconsistently utilize the ethics consultation service (ECS). Methods: Pediatricians in two suburban, Midwestern academic hospitals were asked to reflect on their ethics training and utilization of ECS via an anonymous, electronic survey distributed in 2017 and 2018, and analyzed in 2018. Participants reported their clinical experience, exposure to formal and informal ethics training, use of formal and informal ethics consultations, and potential barriers to formal consultation. Results: Less experienced pediatricians were more likely to utilize formal ethics consultation and more likely to have formal ethics training. The most commonly reported reasons not to pursue formal ECS consultation were inconvenience and self-reported expertise in pediatric ethics. Conclusions: These results inform ongoing discussions about ethics consultation among pediatricians and the role of formal ethics training in both undergraduate and graduate medical education.

Keywords:

• healthcare ethics consultation
• ethics consultation
• ethical review
• ethics consultation service
• pediatric ethics

Acknowledgements

The authors wish to thank their anonymous reviewers and Drs. Brian Berman, Michele Gornick, Patrick Karabon, and Paul Reitemeier for their assistance with this project.

Conflicts of interest

The Authors declare that there is no conflict of interest and that they have no financial relationships relevant to this article to disclose.

Ethical approval

This study was approved by the institutional review boards at Oakland University and University of Michigan.

Contributor statements

Dr Navin conceptualized and designed the study, designed the data collection instrument, coordinated and supervised data collection at one of the two sites, carried out the initial analysis, drafted the initial manuscript, reviewed and revised the manuscript, and approved the final manuscript as submitted.

Dr Wasserman conceptualized and designed the study, designed the data collection instrument, coordinated and supervised data collection at one of the two sites, carried out the initial analysis, reviewed and revised the manuscript, and approved the final manuscript as submitted.

Ms Jain conceptualized and designed the study, designed the data collection instrument, reviewed and revised the manuscript, and approved the final manuscript as submitted.

Drs Baughman and Laventhal coordinated and supervised data collection at one of the two sites, reviewed and revised the manuscript, and approved the final manuscript as submitted.