Is evaluating ethics consultation on the basis of cost a good idea?

Cambridge Quarterly of Healthcare Ethics

Volumn 14, Issue 1, 2005, Pages 57-64

  Mills, Ann E ^a   Tereskerz, Patricia ^a   Davis, Walt ^a  

^a UNIVERSITY OF VIRGINIA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

COST BENEFIT ANALYSIS; EVALUATION; HUMAN; MEDICAL ETHICS; MEDICAL PRACTICE; QUALITY CONTROL; REVIEW;

EID: 13644249847     PISSN: 09631801     EISSN: None     Source Type: Journal    
DOI: 10.1017/s0963180105050073     Document Type: Review

References (32)

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3. In 1996, a grant from the Agency of Health Care Policy and Research (now the Agency for Healthcare Research and Quality) and the National Institute on Aging Claude D. Pepper Older American Independence Center was made available for prominent clinical ethicists to address questions arising from evaluation of the ethics consultation. One primary reason for the exploration was "that in an economic environment characterized by shrinking resources and increased scrutiny, it is increasingly imperative that healthcare practices justify their expenditures by proving their value." Tulsky JA, Fox E. Evaluating ethics consultation: Framing the questions. Journal of Clinical Ethics 1996;7(2):109-15, at 109.
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8. Bacchetta MD, Fins JJ. The economics of clinical ethics programs: A quantitative justification. Cambridge Quarterly of Healthcare Ethics 1997;6:451-60; Daly G. Ethics and economics. Nursing Economics 2000; 18(4). Available at http://web2.infotrac.galegroup.com/itw/infomark/821/ 646/44155453w2/purl=rc2_ITOF_1_ethics+consultations. Accessed Dec. 2, 2003; Dowdy M, Robertson C, Bander J. A study of proactive ethics consultation for critically and terminally ill patients. Critical Care Medicine 1998;26:252-9; Heilicser BJ, Meltzer D, Siegler M. The effect of clinical medical ethics consultation on healthcare costs. Journal of Clinical Ethics 2000;11(1):31-8; Schneiderman LJ, Gilmer T, Teetzel HD. Ethics consultations in the intensive care unit (ICU) reduced duration of ICU stay and time on aggressive, life sustaining treatments with no change in overall mortality. Evidence-Based Nursing 2001;4(4):119.
9. Bacchetta MD, Fins JJ. The economics of clinical ethics programs: A quantitative justification. Cambridge Quarterly of Healthcare Ethics 1997;6:451-60; Daly G. Ethics and economics. Nursing Economics 2000; 18(4). Available at http://web2.infotrac.galegroup.com/itw/infomark/821/ 646/44155453w2/purl=rc2_ITOF_1_ethics+consultations. Accessed Dec. 2, 2003; Dowdy M, Robertson C, Bander J. A study of proactive ethics consultation for critically and terminally ill patients. Critical Care Medicine 1998;26:252-9; Heilicser BJ, Meltzer D, Siegler M. The effect of clinical medical ethics consultation on healthcare costs. Journal of Clinical Ethics 2000;11(1):31-8; Schneiderman LJ, Gilmer T, Teetzel HD. Ethics consultations in the intensive care unit (ICU) reduced duration of ICU stay and time on aggressive, life sustaining treatments with no change in overall mortality. Evidence-Based Nursing 2001;4(4):119.
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11. Bacchetta MD, Fins JJ. The economics of clinical ethics programs: A quantitative justification. Cambridge Quarterly of Healthcare Ethics 1997;6:451-60; Daly G. Ethics and economics. Nursing Economics 2000; 18(4). Available at http://web2.infotrac.galegroup.com/itw/infomark/821/ 646/44155453w2/purl=rc2_ITOF_1_ethics+consultations. Accessed Dec. 2, 2003; Dowdy M, Robertson C, Bander J. A study of proactive ethics consultation for critically and terminally ill patients. Critical Care Medicine 1998;26:252-9; Heilicser BJ, Meltzer D, Siegler M. The effect of clinical medical ethics consultation on healthcare costs. Journal of Clinical Ethics 2000;11(1):31-8; Schneiderman LJ, Gilmer T, Teetzel HD. Ethics consultations in the intensive care unit (ICU) reduced duration of ICU stay and time on aggressive, life sustaining treatments with no change in overall mortality. Evidence-Based Nursing 2001;4(4):119.
12. In 1996, James Tulsky and Ellen Fox comprehensively critiqued the evaluations that had been completed concerning the ethics consultation. Although they found that all the studies had methodological flaws, they also found helpful information in that outcomes (or effectiveness) studies did demonstrate that the majority of physicians requesting consultations did appreciate them. See note 3, Tulsky, 1996. Also see Yen B, Schneirderman LJ. Impact of pediatric ethics consultations on patients, families, physicians, and social workers. American Journal of Perinatology 1999;19:373-8.
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