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  1. Ethics Consultation in U.S. Pediatric Hospitals: Adherence to National Practice Standards.Helena Arango, Colette Gramszlo, Jaideep Grewal, Arzu Cetin, Meaghann Weaver & Jennifer K. Walter - forthcoming - AJOB Empirical Bioethics.
    Background The American Society for Bioethics and Humanities (ASBH), a professional organization that certifies ethics consultants who pass the qualifying examination, published standards for the conduct of ethics consultations (EC). A national survey of adult hospital ethics consultants identified adherence to these standards, but no assessment of pediatric hospitals’ adherence has been done.Methods In this cross-sectional study, a national questionnaire was distributed electronically in 2022 to pediatric ethics consultants at children’s hospitals, collecting information about adherence to the ASBH standards. Hospital (...)
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  • Organizational Ethics in Healthcare: A National Survey.Kelly Turner, Tim Lahey, Becket Gremmels, Jason Lesandrini & William A. Nelson - 2024 - HEC Forum 36 (4):559-570.
    Organizational ethics—defined as the alignment of an institution’s practices with its mission, vision, and values—is a growing field in health care not well characterized in empirical literature. To capture the scope and context of organizational ethics work in United States healthcare institutions, we conducted a nationwide convenience survey of ethicists regarding the scope of organizational ethics work, common challenges faced, and the organizational context in which this work is done. In this article, we report substantial variability in the structure of (...)
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  • Reimagining Thriving Ethics Programs without Ethics Committees.Hilary Mabel, Joshua S. Crites, Thomas V. Cunningham & Jordan Potter - 2023 - American Journal of Bioethics:1-16.
    With the increasing professionalization of clinical ethics, some hospitals and health systems utilize both ethics committees and professional clinical ethicists to address their ethics needs. Drawing upon historical critiques of ethics committees and their own experiences, the authors argue that, in ethics programs with one or more professional clinical ethicists, ethics committees should be dissolved when they fail to meet minimum standards of effectiveness. The authors outline several criteria for assessing effectiveness, describe the benefits of a model that places primary (...)
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  • (2 other versions)Ethics Consultation in U.S. Hospitals: New Findings about Consultation Practices.Ellen Fox, Marion Danis, Anita J. Tarzian & Christopher C. Duke - 2022 - AJOB Empirical Bioethics 13 (1):1-9.
    BackgroundWhile previous research has examined various aspects of ethics consultation (EC) in U.S. hospitals, certain EC practices have never been systematically studied.MethodsTo address this gap, we surveyed a random stratified sample of 600 hospitals about aspects of EC that had not been previously explored.ResultsNew findings include: in 26.0% of hospitals, the EC service performs EC for more than one hospital; 72.4% of hospitals performed at least one non-case consultation; in 56% of hospitals, ECs are never requested by patients or families; (...)
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  • Establishing a clinical ethics support service: lessons from the first 18 months of a new Australian service – a case study.Elizabeth Hoon, Jessie Edwards, Gill Harvey, Jaklin Eliott, Tracy Merlin, Drew Carter, Stewart Moodie & Gerry O’Callaghan - 2023 - BMC Medical Ethics 24 (1):1-9.
    Background Although the importance of clinical ethics in contemporary clinical environments is established, development of formal clinical ethics services in the Australia health system has, to date, been ad hoc. This study was designed to systematically follow and reflect upon the first 18 months of activity by a newly established service, to examine key barriers and facilitators to establishing a new service in an Australian hospital setting. Methods: how the study was performed and statistical tests used A qualitative case study (...)
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  • Coverage Error and Generalizability: Concerns about the “Views in Bioethics Survey”.Ellen Fox & Jason Adam Wasserman - 2024 - American Journal of Bioethics 24 (9):63-66.
    Coverage error is an important type of error that occurs in survey studies when there is a mismatch between the target population and the sampling frame from which a sample is drawn. Coverage error...
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  • Clinical Ethics Fellowship Programs in the U.S. and Canada: A Descriptive Study of Program Characteristics and Practices.Ellen Fox & Jason Adam Wasserman - forthcoming - American Journal of Bioethics:1-16.
    To address the current lack of knowledge about clinical ethics fellowship programs (CEFPs), we surveyed all 36 programs in the U.S. and Canada. The number of CEFPs has grown exponentially over the last 40 years and far exceeds previous estimates. Commonalities among CEFPs include: 88.8% require an advanced degree or rarely accept applicants without one; 91.7% of programs do not restrict applicants to a specific background such as medicine or philosophy; and 88.9% of programs compensate fellows. CEFPs vary widely on (...)
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  • The Structure of Clinical Ethical Decision-Making: A Hospital System Needs Assessment.Leana G. Araujo, Martin Shaw & Edwin Hernández - forthcoming - HEC Forum:1-14.
    Bioethical dilemmas can emerge in research and clinical settings, from end-of-life decision-making to experimental therapies. The COVID-19 pandemic raised serious ethical challenges for healthcare organizations, highlighting the need to conduct needs assessments of the bioethics infrastructures of healthcare organizations. Clinical ethics committees (CECs) also create equitable policies, train staff on ethics issues, and play a consultative role in resolving the difficulty of complex individual cases. The main objective of this project was to conduct a needs assessment of the bioethics infrastructure (...)
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  • A review of clinical ethics consultations in a regional healthcare system over a two-year timeframe. [REVIEW]Graham Anderson, Jacob Hodge, Dean Fox, Stacey Jutila & Catherine McCarty - 2024 - BMC Medical Ethics 25 (1):1-8.
    Clinical Ethics Consultations (CECs) are used by healthcare systems to offer healthcare practitioners a structured level of support to approach ethical questions. The objective of this study was to detail the elements of surveyed CECs and offer guidance in the approach to future ethics consultations at a regional healthcare system. This cohort study has a qualitative and quantitative retrospective approach, surveying ethics consultations through the dates of 4/27/22 to 4/26/24. A documentary sheet was created, and information was entered via online (...)
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  • Demand and Supply: Association between Pediatric Ethics Consultation Volume and Protected Time for Ethics Work.Meaghann S. Weaver, Christopher Wichman, Shiven Sharma & Jennifer K. Walter - 2023 - AJOB Empirical Bioethics 14 (3):135-142.
    Background Despite national increase in pediatric ethics consultation volume over the past decade, protected time and resources for healthcare ethics consultancy work has lagged.Methods Correlation study investigating potential associations between ethics consult volume reported by recent national survey of consultants at children’s hospitals and five programmatic domains.Results 104 children’s hospitals in 45 states plus Washington DC were included. There was not a statistically significant association between pediatric ethics consult volume and hospital size, rurality of patient population, or number of consultants. (...)
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  • Ethical Challenges Experienced by Clinical Ethicists during COVID-19.Connie M. Ulrich, Janet A. Deatrick, Jesse Wool, Liming Huang, Nancy Berlinger & Christine Grady - 2023 - AJOB Empirical Bioethics 14 (1):1-14.
    Background The COVID-19 pandemic continues to disrupt every society as SARs-CoV-2 variants surge among the populations. Health care providers are exhausted, becoming ill themselves, and in some instances have died. Indeed, hospitals are struggling to find staff to care for critically ill patients most in need. Previous work has reported on the unending work-related conditions that hospital staff are laboring under and their subsequent mental and physical health strains. Health care providers need support, but it is not clear where that (...)
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  • Ethics Consultant Training Standards: Don't Lower the Bar Without Benefit.Lynn Sipsey & Joan Henriksen - 2022 - American Journal of Bioethics 22 (4):67-69.
    In “Ethics Consultation in U.S. Hospitals: Opinions of Ethics Practitioners,” Fox and colleagues note that despite efforts of the American Society for Bioethics and Humanities to impr...
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  • Positioning Ethics When Direct Patient Care is Prioritized: Experiences from Implementing Ethics Case Reflection Rounds in Childhood Cancer Care.Pernilla Pergert, Bert Molewijk & Cecilia Bartholdson - forthcoming - HEC Forum:1-12.
    Caring for children with cancer involves complex ethical challenges. Ethics Case Reflection (ECR) rounds can be offered to support teams to reflect on challenges and what should be done in patient care. A training course, for facilitators of ECR rounds, has been offered to healthcare professionals (HCPs) in childhood cancer care by a Nordic working group on ethics. During/after the course, the trainees implemented and facilitated ECR rounds in their clinical setting. The aim was to explore the trainees’ experiences of (...)
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