Journal of Nursing

A RETROSPECTIVE REVIEW OF CLINICAL ETHICS CONSULTATIONS REQUESTED BY NURSES FOR ONCOLOGY PATIENTS

Colleen Mary Gallagher, Megan Ball Neel, Claudia R. Sotomayor

Abstract


Background: With growing importance of clinical ethics in daily nursing practice, and the increasing occurrence and utilization of ethics consultation nationwide, awareness about the motives behind consults is vital to enhancing patient care.Aim: to determine the predominant requests for ethics consultation from nurses in a cancer setting. Design: This is a retrospective data review of the ethics consultations recorded in the clinical ethics consultation database. The data reviewed consist of the ethics consults requested by nurses from records in the database of consultations conducted from January 1, 2008 through July 31, 2013. Findings: The predominant reason for requesting an ethics consult was the level of appropriate care with a total of 27 consults (28%). Within this topic, there were ten consults about the shift from curative care to palliative care, 13 about code status, 2 about general appropriate level of care and 2 regarding hospice.Discussion: The data show that the nurses at this hospital had similar concerns as other nurses in the literature in that there were several requests for concerns regarding code status, informed consent, and appropriate treatment, including the decision to withhold or withdraw life-sustaining therapies.Conclusion: Improving access to ethics consultation services access and the ethics education for nursing staff are necessary steps to improve confidence among them to engage more often with clinical ethics consultation.  

Keywords


Clinical Ethics Consultation; nursing ethics.

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References


Fleetwood, J., Arnold, R., & Baron, R. (1989). Giving Answers or Raising Questions?: The Problematic Committees. Journal of Medical Ethics, 15(3), 137-142.Role of Institutional Ethics

Caulfield, S. (2007). Health care facility ethics committees: New issues in the Age of transparency. Human Rights, 34(4), 10.

Courtwright, A., Brackett, S., Cist, A., Cornelia Cremens, M., Krakauer, E. L., & Robinson, E. M. (2014). The Changing Composition of a Hospital Ethics Committee: A Tertiary Care Center’s Experience. HEC Forum, 26(1), 59-68 10p. doi:10.1007/s10730-013- 9218-0

Tarzian, & ASBH Core Competencies Update Task Force. (2013). Health Care Ethics Consultation: An Update on Core Competencies and Emerging Standards from the American Society for Bioethics and Humanities’ Core Competencies Update Task Force. The American Journal of Bioethics, 13(2), 3-13.

Cohen, J. S., & Erickson, J. M. (2006). Ethical dilemmas and moral distress in oncology nursing practice. Clin J Oncol Nurs, 10(6), 775-780. doi: 10.1188/06.cjon.775-780

Grady, C., Danis, M., Soeken, K. L., O'Donnell, P., Taylor, C., Farrar, A., & Ulrich, C. M. (2008). Does ethics education influence the moral action of practicing nurses and social workers? Am J Bioeth, 8(4), 4-11. doi: 10.1080/15265160802166017

Oberle, K., & Hughes, D. (2001). Doctors' and nurses' perceptions of ethical problems in end-of-life decisions. J Adv Nurs, 33(6), 707-715.

Woods, M. (2005). Nursing ethics education: are we really delivering the good(s)? Nurs Ethics, 12(1), 5-18.

Zuzelo, P. R. (2007). Exploring the moral distress of registered nurses. Nurs Ethics, 14(3), 344-359. doi: 10.1177/0969733007075870

Redman, B. K., & Fry, S. T. (2000). Nurses’ ethical conflicts: What is really known about them? Nursing Ethics, 7(4), 360-366. doi:10.1191/096973300667705066

MD Anderson (2017) Quick Facts. Retrieved on 11/30/17 at: https://www.mdanderson.org/documents/about-md-anderson/about-us/facts-and-history/quick-facts.pdf

Fox, E., Myers, S., & Pearlman, R. A. (2007). Ethics consultation in United States hospitals: a national survey. Am J Bioeth, 7(2), 13-25. doi: 10.1080/15265160601109085

Nilson, E. G., Acres, C. A., Tamerin, N. G., & Fins, J. J. (2008). Clinical ethics and the quality initiative: a pilot study for the empirical evaluation of ethics case consultation. Am J Med Qual, 23(5), 356-364. doi: 10.1177/1062860608316729

Schneiderman, L. J., Gilmer, T., Teetzel, H. D., Dugan, D. O., Blustein, J., Cranford, R., Young, E. W. (2003). Effect of ethics consultations on nonbeneficial life-sustaining treatments in the intensive care setting: a randomized controlled trial. JAMA, 290(9), 1166-1172. doi: 10.1001/jama.290.9.1166

American Cancer Society, I. (2014). Cancer Facts & Figures 2014 (pp. 70). Atlanta: American Cancer Society.

Doane, G., Pauly, B., Brown, H., & McPherson, G. (2004). Exploring the heart of ethical nursing practice: implications for ethics education. Nurs Ethics, 11(3), 240-253.

Kalaitzidis, E., & Schmitz, K. (2012). A study of an ethics education topic for undergraduate nursing students. Nurse Educ Today, 32(1), 111-115. doi: 10.1016/j.nedt.2011.02.006

Kearney, G., & Penque, S. (2012). Ethics of everyday decision making. Nurs Manag (Harrow), 19(1), 32-36. doi: 10.7748/nm2012.04.19.1.32.c9015




DOI: http://dx.doi.org/10.18686/jn.v7i1.137

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