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Seeking to Reduce Nonbeneficial Treatment in the ICU: An Exploratory Trial of Proactive Ethics Intervention

Posted Dec 09 2013 10:12am
Prior studies have demonstrated the value of ethics consultations in resolving conflict and reducing both length of stay and use of aggressive therapies.  In a new just-published study Anderdeck, Schneiderman & Jonsen report on a trial of proactive ethics intervention.  Unfortunately, the results are not encouraging.

The aim of the Proactive Ethics Intervention study was to investigate whether the proactive intervention of a clinical ethicist in cases with critical care stays of at least 5 days reduces non-beneficial treatments while increasing perceived patient / surrogate and provider satisfaction and reducing associated costs.

But the authors found that a Proactive Ethics Intervention offered to all patients in the ICU for at least 5 days did not affect perceptions of quality, reduce non-beneficial treatments, or have an impact on cost in patients who did not survive.  

The authors observed: "An ethics intervention in the absence of an ethical conflict, or without the underlying sense of ethical disquiet that usually overtakes a medical team or family during an ethics consultation, does not seem to be effective in reducing non-beneficial treatments."

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