Background Medical ethics and palliative medicine consultation services frequently intersect. Understanding such overlap may provide clarity regarding the roles and strengths of each service.
Aim To determine how often patients at the Mayo Clinic (Rochester, MN, USA) who receive an ethics consult also receive a palliative medicine consult and to determine which service was consulted initially.
Methods Ethics consultations at our institution were reviewed for the years 2007 to 2014, examining overlap between ethics and palliative care consults. Query included the total number of ethics consultations for the time period, the number of patients receiving both ethics and palliative medicine consultation, and which service was consulted first.
Results Between 2007 and 2014, 566 ethics consults were ordered. Of these, 265 patients (47%) also received a palliative care consult. In 144 of the 265 cases, the ethics consult was placed prior to the palliative medicine consult. The ethics service requested palliative care involvement in 107 of those 144 cases. In 121 of the 265 cases, palliative care consultation preceded ethics consultation and requested ethics involvement for 37 of the 121 patients.
Discussion There is significant overlap with palliative medicine in patients receiving ethics consults at our institution. However, the requests for interaction with the other service in our review highlight that there are likely clear strengths of each service.
Conclusion Current literature suggests frequent overlap in consults between ethics and palliative medicine at many institutions. Further research to understand those trends may help further clarify the relative strengths, and thus the roles, of those services.
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