Clinical ethics and the quality initiative: A pilot study for the empirical evaluation of ethics case consultation Academic Article uri icon


MeSH Major

  • Ethics Consultation
  • Ethics, Clinical
  • Quality of Health Care
  • Terminal Care


  • The Institute of Medicine's quality imperatives include the need to provide safe, effective, patient-centered, timely, efficient, and equitable care. Less attention has been paid to quality metrics as they relate to the assessment of clinical ethics consultation and its impact on care. A better understanding of how ethics consultation influences the quality of care might identify opportunities for improvement. A descriptive pilot study, involving 7 hospitals in the New York-Presbyterian Healthcare System, was conducted to identify key elements of the ethics consultative process that might impact clinical and psychosocial outcomes. A majority of consults involved medical or intensive care unit patients and end-of-life decision making; 75.5% had or received a do-not-resuscitate order, 90.6% lacked decision-making capacity, 43.4% had an advance directive. Conflict existed in a majority. Future research should include surrogate decision making, patients on nonmedical services who may have unrecognized ethical dilemmas, and the role of conflict in clinical care.

publication date

  • September 2008



  • Academic Article



  • eng

Digital Object Identifier (DOI)

  • 10.1177/1062860608316729

PubMed ID

  • 18820140

Additional Document Info

start page

  • 356

end page

  • 64


  • 23


  • 5