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Purpose: As the role of clinical ethics consultation in health care advances, there are calls to standardize the process of consultation. The Ethics Committee at Memorial Sloan Kettering Cancer Center (MSK) hypothesized that the process of requesting an ethics consultation could be improved by instituting an electronic health record (EHR) order for consultation requests. This report summarizes the impact of adopting an EHR order for ethics consultation requests at MSK.
Methods: This retrospective review of all clinical ethics consultations requested at a tertiary cancer center from May 2017 to February 2020 spans 17 months before and after implementation of an electronic order for consultation requests. Summary statistics are presented using Pearson chi-square analyses with a significance level of 0.05.
Results: There was a significant increase in the total number of consultation requests placed after implementation of the EHR order (n = 165, 0.08% of total patients) compared with before (n = 108, 0.05% of total patients; = .007). The number of consults requested by providers from inpatient ( = .02) and outpatient ( = .04) settings significantly increased. The proportion of consults placed by medical versus nonmedical providers remained unchanged ( = .32).
Conclusion: In this large single-institution retrospective study, implementation of an EHR order for ethics consultation requests was associated with a significant increase in the number of consultation requests. Implementation of an electronic order may decrease barriers to ethics consultation in diverse practice settings. Further longitudinal, multicenter studies are needed to assess strategies to improve access to clinical ethics consultation for oncology patients.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9509102 | PMC |
http://dx.doi.org/10.1200/OP.22.00174 | DOI Listing |
Nurs Inq
October 2025
Clinical Ethics and Spiritual Care Service, Provincial Health Services Authority, Vancouver, British Columbia, Canada.
Moral distress increased among healthcare workers during the first three years of the COVID-19 pandemic. This qualitative descriptive study explored the experiences of thirteen healthcare professionals with expertise in supporting healthcare workers experiencing moral distress within Canadian healthcare systems during this time. Participants reported multiple factors driving moral distress, such as resource scarcity (e.
View Article and Find Full Text PDFBMC Health Serv Res
September 2025
Institute of General Practice, Rostock University Medical Center, Doberaner Str. 142, Rostock, 18057, Germany.
Background: Post-viral syndromes, including long- and post-COVID, often lead to persistent symptoms such as fatigue and dyspnoea, affecting patients' daily lives and ability to work. The COVI-Care M-V trial examines whether interprofessional, patient-centred teleconsultations, initiated by general practitioners in cooperation with specialists, can help reduce symptom burden and improve care for patients.
Methods: To evaluate the effectiveness of the intervention under routine care conditions, a cluster-randomised controlled trial is being conducted.
Eur Urol Focus
September 2025
Department of Urology, Medical Centre, University of Heidelberg, Heidelberg, Germany; Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany; Department of Urology, Philipps-University Marburg, Marburg, Germany.
Background And Objective: Since 2016, >21 000 patients with prostate cancer (PC) used our personalized online decision aid in routine care in Germany. We analyzed the effects of this online decision aid for men with nonmetastatic PC in a randomized controlled trial.
Methods: In the randomized controlled EvEnt-PCA trial, 116 centers performed 1:1 allocation of 1115 patients with nonmetastatic PC to use an online decision aid (intervention = I) or a printed brochure (control = C).
Eur J Trauma Emerg Surg
September 2025
Emergency Medical Services of Karlovy Vary Region, Zavodni 390/98C, Karlovy Vary, 36006, Czech Republic.
Background And Importance: In the Czech Republic, paramedics are required to consult a physician before administering intravenous opioids, which may delay effective prehospital pain management. As paramedic competencies expand in Europe, it is important to evaluate the safety and efficacy of independent opioid administration in prehospital emergency care settings.
Objectives: To assess the safety and effectiveness of intravenous sufentanil administered independently by trained paramedics compared to administration following remote physician consultation in adult trauma patients.
Psychiatr Serv
September 2025
Department of Psychiatry, Columbia University, New York.
The insanity defense is intended to negate the culpability of defendants who cannot fairly be held responsible for behavior that was due to their mental illness. Does the calculus change when the defendant may have self-induced an impaired mental state by failing to take prescribed medication? That question was considered by the Georgia courts in the case of a woman with bipolar disorder whose reckless driving led to the death of a 5-year-old child. One of the few states to have addressed this issue, Georgia looked to the terms of its insanity defense statutes to come up with an answer.
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