Seeking to reduce nonbeneficial treatment in the ICU: an exploratory trial of proactive ethics intervention*.

Objective: To investigate whether the proactive intervention of a clinical ethicist in cases of prolonged lengths of stay in a critical care setting reduces nonbeneficial treatment while increasing perceived patient/surrogate and provider satisfaction and reducing associated costs. Nonbeneficial treatment is defined here as the use of life-sustaining treatments delivered to patients who had been in the ICU for 5 days and did not survive to discharge.

Design: Prospective randomized exploratory trial from October 2007 to February 2010 in the adult ICU of a large, urban, not-for-profit community hospital.

The clinical ethics consultant: verifying the qualifications of a new type of practitioner in a community hospital.

Ethics consultation has been occurring in various forms within hospitals for more than 30 years. These consultations constitute a clinical act, and as such, the qualifications of those who provide them must be verified by the hospitals at which the ethics consultants practice. The clinical nature of the practice exposes the participants to malpractice liability.