First name
Leslie
Last name
Kersun

Title

Pediatricians' Experience with Clinical Ethics Consultation: A National Survey.

Year of Publication

2015

Number of Pages

919-924.e1

Date Published

2015 Oct

ISSN Number

1097-6833

Abstract

OBJECTIVE: To conduct a national survey of pediatricians' access to and experience with clinical ethics consultation.

STUDY DESIGN: We surveyed a randomly selected sample of 3687 physician members of the American Academy of Pediatrics. We asked about their experiences with ethics consultation, the helpfulness of and barriers to consultation, and ethics education. Using a discrete choice experiment with maximum difference scaling, we evaluated which traits of ethics consultants were most valuable.

RESULTS: Of the total sample of 3687 physicians, 659 (18%) responded to the survey. One-third of the respondents had no experience with clinical ethics consultation, and 16% reported no access to consultation. General pediatricians were less likely to have access. The vast majority (90%) who had experience with consultation had found it helpful. Those with fewer years in practice were more likely to have training in ethics. The most frequently reported issues leading to consultation concerned end-of-life care and conflicts with patients/families or among the team. Intensive care unit physicians were more likely to have requested consultation. Mediation skills and ethics knowledge were the most highly valued consultant characteristics, and representing the official position of the hospital was the least-valued characteristic.

CONCLUSION: There is variability in pediatricians' access to ethics consultation. Most respondents reported that consultation had been helpful in the past. Determining ethically appropriate end-of-life care and mediation of disagreements are common reasons that pediatricians request consultation.

DOI

10.1016/j.jpeds.2015.06.047

Alternate Title

J. Pediatr.

PMID

26210945

Title

CLL/SLL diagnosed in an adolescent.

Year of Publication

2014

Number of Pages

1107-10

Date Published

2014 Jun

ISSN Number

1545-5017

Abstract

<p>Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is a disease of older adults. Pediatric CLL/SLL is vanishingly rare in the literature. We present a case of CLL/SLL diagnosed in a 17-year-old male. The pathologic findings of this case were those of classic CLL/SLL with an ATM deletion, a characteristic genetic abnormality in CLL/SLL. Management guidelines for CLL/SLL are tailored to older adults making determination of the optimal therapy for this patient a unique challenge.</p>

DOI

10.1002/pbc.24884

Alternate Title

Pediatr Blood Cancer

PMID

24281971

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