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At least 559 records · Page 31Linked to original sources
PubMed2007

Impact of decision-making in a multidisciplinary perinatal team.

OBJECTIVES: (1) To describe the characteristics of decision-making about management of unborn infants with serious anomalies by a multidisciplinary perinatal team. (2) To evaluate the impact of multidisciplinary team discussions on the degree to which decisions about the management of unborn infants with serious anomalies are supported. (3) To evaluate the impact of the team discussions on the arguments used by physicians for their preferences concerning management. METHODS: Prospective analysis of 78 cases discussed within the multidisciplinary perinatal team of a tertiary centre by means of an anonymous one-page questionnaire with structured questions pertaining to the opinion of the responder on medical management of each case. RESULTS: We did not find systematic differences between specialties prior to the discussion of cases. However, discussion with the multidisciplinary perinatal team improved decision-making about management of unborn infants with serious anomalies by enhancing the degree of support for the decisions taken. The discussions of the team did not change the physicians' arguments mentioned for their preferences. CONCLUSION: Multidisciplinary team discussions improve decision-making about management of unborn infants with serious congenital anomalies.

Adult↗
PubMed1990

Improving hospital ethics committees: testing an educational model.

Overall, the project described in this paper appears to represent a considerable success in the field of postsecondary education, moving from the identification of a population with special educational needs to the implementation of a well-received program in a two year period. The extensive curriculum developed for the project seems to have been appreciated by participants and, in the case of relatively new members, to have improved their readiness to participate in committee work. Even in the case of more experienced HEC members, participation may have had significant, if unmeasureable, benefits. As one experienced HEC member noted, "It was a very stimulating, challenging, exhausting week and one I would recommend to others." These sentiments were echoed by another experienced participant who indicated that, "In the brochure the seminar looked like it might turn out to be the 'same old thing,' but it turned out to be a challenge and a chance to go home and begin again at a 'higher level'." Beyond its immediate benefits to individual participants, the project has led to the completion of 21 participant papers on procedural and bioethical issues, and the founding of a new journal for HEC members in which they will be published (HEC Forum, Pergamon Press, Oxford and New York). For the project faculty, the challenge ahead will be not only to respond to participant concerns, but to adapt the curriculum for presentation "on site" at hospitals across the country. While the move from formal demonstration to full-scale implementation will allow new flexibility, care must be taken to ensure that any changes do not sacrifice the program's clearly documented strengths.(ABSTRACT TRUNCATED AT 400 WORDS)

Bioethical Issues↗
PubMed1991

Hospital ethics committees in Quebec: an overview.

In June 1989, La Direction de la Sante physique (ministere de la Sante et des Services sociaux) (MSSS) undertook a major research project focusing on ethics committees in Quebec, in cooperation with Laval University's Groupe de recherche en Ethique Medicale (GREM). Initially, three major objectives were set out: to prepare a faithful overview of ethics committees in Quebec; to inform all those involved of the available resources, and to collect the data required to eventually carry out in-depth research on ethics committees. A number of government documents refer to the existence of ethics committees, whether to request their cooperation or to entrust mandates to them; moreover, the Law Reform Commission of Canada recently published a document that proposed establishing a Canadian Advisory Council on Biomedical Ethics. The MSSS, therefore, had to study the situation in Quebec with regard to ethics committees in order to be in a position to clarify its position in future discussions. This overview is the outcome of the first stage of this research project. Essentially, it represents the first of three main sections of a single document. It [1] presents general data on ethics committees, [2] contains a description of each committee by socio-sanitary region and type of committee, and in section three it deals with the principal resources available in bioethics in Quebec, Canada, and throughout the world.

Clinical Protocols↗
PubMed1991

A survey of New Jersey hospital ethics committees.

A mail survey in 1988 of all 108 hospitals in New Jersey, and telephone follow-up in 1990, investigated the extent and structure of ethics committees with attention to the distinctions between prognosis, infant care review committees (ICRC) and general ethics committees (HECs). It disclosed that as of August, 1990, 74 hospitals had prognosis committees, 16 had ICRCs, and 64 had HECs. All types of committees tend to cluster in teaching hospitals and in hospitals with 200-500 beds. HECs average 13 members which include 4-5 physicians, 2-3 nurses, administrators and clergy (1-2 each), and fewer than one each for any other single profession. The primary purpose of HECS is to develop hospital ethics policy (96%), followed by educating hospital staff (80%), and providing counsel and support to physicians (67%). Case review with recommendation is provided by 54% of the HECs and 21% are involved in confirmation of prognosis.

Data Collection↗
PubMed1991

Pastoral care representation on the hospital ethics committee.

A recommendation for pastoral care representation on hospital ethics committees (HEC) is commonplace in the literature, but the rationale for this recommendation (and the actual practice) often is assumed or unarticulated. The authors propose a holistic anthropology which acknowledges the bodily, psychological, and spiritual aspects of all persons as a starting point for discussing the reasons for pastoral care representation. The spiritual aspect of the human person is described together with the role of the clinical chaplain on the HEC. The qualifications, skills, and training required for the HEC representative are also provided.

Clergy↗