A Multi-Center Retrospective Analysis of the Characteristics of Pediatric Patients with Ethics Consults
Thursday, October 12, 2023
8:15 AM – 9:30 AM ET
Location: Atlantic (Third Floor)
As pediatric healthcare becomes increasingly complex, providers more often request clinical ethics consultations (CECs) to navigate ethically and morally challenging situations. Prior studies describe the ethical issues raised by and outcomes of pediatric CECs at single centers. Despite increased utilization of CECs in pediatrics, no multi-center study characterizes the pediatric patients who receive CECs, what ethical issues predominate, and what outcomes are achieved. Notably, no published data describe the relationship between racial or socioeconomic characteristics and pediatric patients who receive CECs. We will present data from a study that fills those literature gaps. Our multi-center retrospective study collects and analyzes data about pediatric CECs conducted from 2016-2021 at five geographically diverse, academic pediatric centers. This study describes the population for whom pediatric CECs are requested as well as the indications and outcomes of those consults using the Armstrong Clinical Ethics Coding System (ACECS) taxonomy. We also analyze differences in the patient population between institutions. We hypothesize that there are racial, ethnic, and/or socioeconomic differences between those pediatric patients receiving ethics consults and the general pediatric population at each site. This study explores several unanswered questions within clinical bioethics including: Who are the pediatric patients receiving CECs? How do these populations differ between institutions? Finally, are there racial, ethnic, socioeconomic, or other disparities related to which patients receive CECs? This work will inform our future work to better understand any disparities discovered and investigate why and how those disparities exist.
Shannon Barnett, MD, MBE – Assistant Professor, Psychiatry, The Johns Hopkins Hospital/Johns Hopkins University School of Medicine; Jenny Kingsley, MD, MA, HEC-C – Assistant Professor, Pediatric Anesthesiology and Critical Care Medicine, Children's Hospital of Los Angeles, Keck School of Medicine at the University of Southern California; Irini Kolaitis, MD – Assistant Professor of Pediatrics, Pediatrics, Ann & Robert H Lurie Children's Hospital/Northwestern University; Kelly Michelson, MD, MPH – Attending Physician/Professor, Division of Critical Care Medicine, Department of Pediatrics, Ann & Robert H Lurie Children's Hospital/Northwestern University; Erin Paquette, MD, JD, MBe, HEC-C – Associate Professor, Pediatrics and Law, Ann & Robert H Lurie Children's Hospital/Northwestern University Feinberg School of Medicine & Pritzker School of Law (by courtesy); Ryan Sutyla, MD – Department of Pediatrics – Monroe Carell Jr. Children's Hospital at Vanderbilt; Holly Vo, MD, MPH, MSc, MA – Assistant Professor, Pediatrics, Seattle Children's Hospital/University of Washington