Pediatric Ethics Consultation in the Outpatient Setting
Thursday, October 12, 2023
8:15 AM – 9:30 AM ET
Location: Atlantic (Third Floor)
There is variability in pediatricians’ access to and utilization of ethics consultation in the United States. Much has been reported on experiences of ethics consultation in the adult population, in part because nationally the volume of adult consults is much higher. The little that has been published on the actual experience with ethics consultation in pediatrics have either described inpatient consultation alone or combined inpatient and outpatient consultation. Given the dearth of information specific to outpatient pediatric ethics consultation, we sought to review a large retrospective sample of pediatric clinical ethics consultations solely in the outpatient setting and to compare them to those reported in the inpatient setting. We hypothesized that the ethical dilemmas pediatricians, patients, and families face in the outpatient setting are not the same as those in the inpatient setting. This presentation summarizes the largest review, to date, of pediatric ethics consultation in the outpatient setting at a large, tertiary academic children’s hospital. We explore the primary ethical concerns and contextual features of these outpatient cases, contrast these with inpatient pediatric ethics consultation, discuss implications for clinical practice, make recommendations for education and training specific to outpatient pediatric ethics consultation for both ethicists and outpatient healthcare teams -- as these can differ from inpatient needs -- and propose ways to reduce barriers to access for ethics consultation in the outpatient setting. While every ethics consult should be done with care, special considerations must be addressed for outpatient pediatric ethics consultation.
John Gerlach – Center for Bioethics and Social Sciences in Medicine – University of Michigan Medical School; Hannah Fagen – Center for Bioethics and Social Sciences in Medicine – University of Michigan Medical School