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May 25, 2021 · Clinical ethical case consultations have been widely implemented in clinical practice. It has been hailed as important tool to support clinical decision making. At the same time, it is a matter of debate what ethical case consultations actually do contribute to clinical practice and what it should actually contribute.
Jul 22, 2019 · Ethical case interventions (e.g. ethics committee, moral case deliberation) identify and analyse ethical conflicts which occur within the context of care for patients. A typical example for situations in which ethical conflicts can arise are cases in which it is uncertain whether provision or limitation of treatment is in line with patients' will or patient welfare (or both).
- Jan Schildmann, Stephan Nadolny, Joschka Haltaufderheide, Marjolein Gysels, Jochen Vollmann, Claudia...
- 10.1002/14651858.CD012636.pub2
- 2017
- 2019
Sep 27, 2022 · CEC is broadly understood as “a service provided by an individual consultant, team, or committee to address the ethical issues involved in a specific clinical case. Its central purpose is to improve the process and outcomes of patient care by helping to identify, analyze, and resolve ethical problems” [ 4 ].
- 10.1186/s12910-022-00832-6
- 2022
- BMC Med Ethics. 2022; 23: 99.
May 18, 2021 · In addition, the ability of ethics consultants to identify ethical issues as well as to apply their knowledge to a case comes into focus.19 45 46 This narrows the focus of endpoints to dimensions of influence on decision-making processes, for example, how helpful a consultation was in determining the further course of treatment, whether it successfully advanced the solution of an ethical ...
- Phase I (Scoping Review) Methods
- Primary Outcomes
- Secondary Outcomes
- Phase II (Qualitative Synthesis) Methods
- Phase III (Quantitative Synthesis) Methods
The aim for phase I is to compile the entire published English language literature that relates directly to quality measurement of CEC and to categorize this literature into relevant study types, findings, and so on. This comprehensive scoping review of the literature will be performed following the steps outlined by Arksey et al. .
A primary outcome of this phase will be a comprehensive listing of potential measures and domains of measurement (i.e., clusters of related measures) for CEC. When considering measures and domains of CEC quality, we will follow the Donabedian Quality-of-Care Framework, which categorizes quality measures as assessing structures, processes, or outcom...
As secondary outcomes, barriers and facilitators to improved quality of CEC noted in the literature will also be compiled.
Eligibility criteria
Because a comprehensive search will be executed for the scoping review in phase I, the search criteria will not differ. All qualitative studies found in the scoping review will be used for the phase II qualitative synthesis.
Search methods for identification of studies
No additional searching of the literature beyond that found in the phase I search will be carried out except in the unlikely event that theory saturation (i.e., the point where the addition of new articles does not add new explanatory theories) is not obtained in the course of the data synthesis described below. This is highly unlikely given the large number of studies anticipated to be found in the initial search (Fig. 1).
Study records and data management
Three reviewers (LL, RC, AM) will perform an analysis on included studies using the qualitative data analysis software Nvivo11s to develop a thematic synthesis of the literature, which is described in more detail in the “Data Synthesis” section below.
Eligibility criteria
Because a comprehensive search will be executed for the scoping review in phase I, the initial search criteria (population, intervention, outcomes, etc.) will not differ. Instead, randomized-controlled trials (RCTs) found in the scoping review will be used for the quantitative synthesis. Non-randomized controlled trials, prospective cohort, and quasi-experimental studies will also be included, since there are very few RCTs, but only if their outcomes and methods are sufficiently similar to th...
Search methods for identification of studies
As noted, the scoping review search strategy is far more comprehensive than a RCT-specific search would be and includes both quantitative and qualitative studies. In piloting electronic search strategies, we found that articles reporting on clinical trials were captured using our broader search strategy as well as by the Cochrane highly sensitive search strategy for identifying randomized trials . For that reason, no specific additional literature searches will be carried out for phase II...
Study records and data management
Initially, reviewers will perform a further in-depth analysis using several extraction tools: 1. Distiller SR, where extraction forms will be used to note demographic and numeric values as well as for performing quality assessment. 2. Nvivo11, where textual data will be extracted. 3. JMP (JMP®, Version 12. SAS Institute Inc., Cary, NC, 1989-2015.), or another statistical analysis software, will be used for the meta-analysis.
- Louis Leslie, Louis Leslie, Rebecca Frances Cherry, Abbas Mulla, Jean Abbott, Kristin Furfari, Jacqu...
- 2016
Oct 1, 2009 · The development of ethics case consultation over the past 30 years, initially in North America and recently in Western Europe, has primarily taken place in the secondary or tertiary healthcare settings. The predominant model for ethics consultation, in some countries overwhelmingly so, is a hospital-based clinical ethics committee.
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Sep 27, 2022 · Background Clinical ethics consultations (CEC) can be complex interventions, involving multiple methods, stakeholders, and competing ethical values. Despite longstanding calls for rigorous evaluation in the field, progress has been limited. The Medical Research Council (MRC) proposed guidelines for evaluating the effectiveness of complex interventions. The evaluation of CEC may benefit from ...
