Standards and Evaluation

The fact that standards and methods for evaluating clinical ethics consultation are not established comes as no surprise.

The infancy of clinical ethics consultation and the disagreement about its goals, as well as the diverse academic and professional backgrounds of its practitioners, account for this lack. Most studies to date have employed physician satisfaction and usage as outcome measures. By this standard, ethics consultations have been judged to be helpful. Critics have pointed out, however, that by not including patient and surrogate satisfaction and reactions of house staff and nurses, an incomplete and perhaps inaccurate picture of ethics consultation is painted (Tulsky and Lo). For example, "it would be hard to argue that it is desirable for an ethics consultant to reject the choices of a competent and informed patient, even if the attending physician expresses satisfaction with such a consultation" (Tulsky and Lo, p. 591). More objective measures like changes in physician behavior, reduction in use of limited resources (Kanoti et al.), and decreased litigation are attractive, but could confuse matters if these goals were achieved at the expense of more traditional values, such as patient autonomy and well-being.

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Anxiety and Depression 101

Everything you ever wanted to know about. We have been discussing depression and anxiety and how different information that is out on the market only seems to target one particular cure for these two common conditions that seem to walk hand in hand.

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