An Ethics Consult Team in Geriatric Long-Term Care
Chichin, Eileen R.
Cambridge Quarterly of Healthcare Ethics. 1995 Spring; 4(2): 178-184.
...As the prevalence of ethical issues affecting institutionalized elderly grows, it is likely that more and more facilities will recognize the need for other types of mechanisms [than ethics committees] to resolve ethical dilemmas. One particularly useful technique used by the Jewish Home and Hospital (JHHA) in New York City is Ethics Rounds. Held on a monthly basis and similar to clinical grand rounds in format, Ethics Rounds is a forum for case review and resolution, and is also a useful teaching technique. With time, however, it was recognized that the major limitation of Ethics Rounds is the inability to address on a timely basis ethical issues that arise on a day-to-day basis. To meet this need, JHHA decided to utilize an ethics consult team. Smaller and more flexible than the typical ethics committee, the consult team has the ability to assemble with relative ease, and go to the bedside when needed. The membership on the consult team includes the major disciplines involved in long-term care: social work, nursing, and medicine, and also has representation from administration, similar to the "core" members of most ethics committees. This group meets periodically on an as-needed basis to review cases. When an ethical dilemma arises, however, a subgroup consisting of two or three members works closely with the primary care team responsible for the care of the resident to resolve the dilemma. This article describes the functioning of the ethics consult team. Additionally, it discusses some of the issues that the ethics consult team found to be especially problematic as it attempted to resolve ethical dilemmas, and the procedures it developed as a result.
Aged; Allowing to Die; Autonomy; Clinical Ethics; Clinical Ethics Committees; Communication; Competence; Consent; Consultation; Decision Making; Dissent; Ethicists; Ethics; Ethics Committees; Ethics Consultation; Family Members; Interdisciplinary Communication; Long-Term Care; Medicine; Nursing Homes; Paternalism; Patient Care; Patient Care Team; Prevalence; Program Descriptions; Review; Values; Withholding Treatment;
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