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PubMed · 7922646

Framework for analyzing an ethical problem and conducting an ethical consultation.

P A Dunn·J Hansen-Flaschen
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Abstract

Clinical ethics are an intrinsic aspect of practice in health care settings. However, health care professionals may have minimal training in ethics and communication. Clinical ethics committees, with a multidisciplinary composition, are in a position to offer clinical consultative services from a collaborative framework. Using this framework, as well as standard guidelines for conducting an ethics consultation, most often elicits essential beliefs, values, concerns, and opinions pertinent to the case at hand. Through enhancement of the communication process, group consensus is usually achieved. The framework guiding the consultation and communication process is delineated and illustrated through case analysis.

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CommunicationEthics CommitteesEthics, NursingGroup ProcessesHumansMaleMiddle AgedNursing RecordsPatient Care TeamProblem SolvingReferral and ConsultationCase ReportsJournal Article

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P A Dunn, J Hansen-Flaschen. 1994. Framework for analyzing an ethical problem and conducting an ethical consultation.. https://pubmed.ncbi.nlm.nih.gov/7922646/

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Information-sharing among couples considering multifetal pregnancy reduction.

OBJECTIVE: To determine the information-sharing strategies of couples considering fetal reduction, and the impact of these strategies on the chances of encountering hostility in their social networks. DESIGN: Cross-sectional design of semistructured qualitative interviews, coded with respect to sharing strategies and level of personally directed hostility encountered. SETTING: Multiple Pregnancy Management Program, Comprehensive Genetics, New York, New York. PATIENT(S) AND INTERVENTION(S): Fifty women and their partners who were making a first visit to our maternal-fetal management facility, in order to consider the possibility of multifetal reduction as a pregnancy-management strategy. MAIN OUTCOME MEASURE(S): Development of information-sharing strategies, and the chances of encountering personally directed hostility regarding multifetal reduction associated with more and less selective strategies. RESULT(S): Four information-sharing strategies emerged from the analysis. Two of these strategies were relatively open (extended network, and both parents). Two other strategies were relatively selective (qualified family and friends, and defended relationship). The selective strategies were significantly less likely to encounter to encounter personally directed hostility (odds ratio, 3.88; 95% confidence intervals, 0.87-17.30). CONCLUSION(S): Selective sharing of information for couples considering multifetal prgnancy reduction is a potentially useful strategy for moderating potentially stressful relationships in their social networks. Clinics should find a way of integrating the discussion of selective sharing into their clinic's cultural repertoire of patient-support services.

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