Ethics Consultation in US Hospitals: A National Follow-Up Study

A 1999-2000 national study of U.S. hospitals raised concerns about ethics consultation (EC) practices and catalyzed improvement efforts. To assess how practices have changed since 2000, we administered a 105-item survey to best informants in a stratified random sample of 600 U.S. general hospitals. This primary article details the methods for the entire study, then focuses on the 16 items from the prior study. Compared with 2000, the estimated number of case consultations performed annually rose by 94% to 68,000. The median number of consults per hospital was unchanged at 3, but more than doubled for hospitals with 400+ beds. The level of education of EC practitioners was unchanged, while the percentage of hospitals formally evaluating their ECS decreased from 28.0% to 19.1%. The gap between large, teaching hospitals and small, nonteaching hospitals widened since the prior study. We suggest targeting future improvement efforts to hospitals where needs are not being met by current approaches to EC.

Automated summary

Since 2000, the number of ethics consultation case performed annually in US hospitals increased by 94% to 68,000, with the average number of consults per hospital remaining unchanged. The level of education of EC practitioners remained the same, but the percentage of hospitals formally evaluating their EC services decreased. The gap between large, teaching hospitals and small, nonteaching hospitals widened compared to the previous study.