Impact of pediatric ethics consultations on patients, families, social workers, and physicians

OBJECTIVE: To evaluate whether health providers and families find ethics consultations helpful in identifying, analyzing, and resolving ethical problems. STUDY DESIGN: Forty consecutive pediatric ethics consultations at the San Diego Children's Hospital and Health Center were evaluated retrospectively through chart reviews and structured interviews with physicians, social workers, and family members. RESULTS: In 23 of 40 cases, physicians or social workers were successfully interviewed. Of these 23 cases, four family interviews were completed. Over 90% of physicians and social workers found the ethics consultation to be helpful and would recommend an ethics consultation to others in the same circumstances. Two of the four families were strongly dissatisfied with the consultation and identified miscommunication of the ethics consultant's role as a major problem. CONCLUSION: The disparity observed in this study between satisfaction levels of health providers and families raises concerns. More studies that evaluate ethics consultations are needed, especially those that are designed prospectively and explore both these perspectives.