A grass roots multidisciplinary bioethics organization in a mid-Atlantic state developed a survey instrument to gain an understanding of how ethics committee members in health care organizations viewed end-of-life care in their facilities. The survey, sent to continuing care retirement communities, long-term care facilities, community and academic hospitals, generated a 37% response rate. To maintain confidentiality, neither names nor professional designations were requested. Consent to participate was indicated by completing and returning the survey. For purposes of analysis and anonymity, the facility types were divided into two broad categories that define their general designation: acute care and non-acute care providers. There were nine acute care facilities, and six non-acute care facilities in the sample. In light of the sample size, a frequency analysis was employed to explore the prevalence of different practices within these two broad categories. Responses include the following: 1) A quarter of responding facilities did not indicate patient wishes as playing any part in resolution over end-of-life conflicts, although all agreed that advance directives impact care; 2) Conflicts between clinicians and the patient/family were more prevalent in acute settings; 3) Frequency of conflicts between clinicians or among family members was similar for acute and non-acute facilities; 4) Two acute care settings reported conflicts about end-of-life care involving insurers. Responses may be indicative of insufficient knowledge about end-of-life care in the facility, but may also illustrate the perplexing nature of end-of-life concepts and terminology and their application in a clinical setting.
Learning Objectives: The participant will: 1) compare reported differences in EOL care between acute and non-acute care facilities with experiences in their own institutions 2) discuss reasons for inconsistencies in perceptions about how EOL care is conceived and practiced
Keywords: Ethics, End-of-Life Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.