Technical Considerations for Implementation of Tele-Ethics Consultation in the Intensive Care Unit

Laura S Johnson, David M Brenner, Nneka O Sederstrom
Journal of Clinical Ethics, 29 (4): 285-290

BACKGROUND: Robust ethics consultation services cannot be sustained by all hospitals; consultative service from a high-volume center via teleconferencing is an attractive alternative. This pilot study was conceived to explore the feasibility and understand the practical implications of offering such a service.

METHODS: High-definition videoconferencing was used to provide real-time interaction between the rounding clinicians and a remote clinical ethicist. Data collection included: (1) evaluation of the hardware and software required for teleconferencing, and (2) comparison of ethics trigger counts between the remote and on-site ethicist during rounds.

RESULTS: Issues with audio represented the majority of technical problems. Once technical difficulties were addressed, the on-site ethicist's count of "triggers" was not statistically different from the count of the remote ethicist.

CONCLUSION: Remote clinical ethics rounding is feasible when the equipment is optimized. Remote ethicists can identify similar numbers of "triggers" for possible ethical issues when compared to on-site ethicist numbers.

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