Ethics rounds do not improve the handling of ethical issues by psychiatric staff
Sammanfattning
Background. One way to support healthcare staff in handling ethically difficult situations is through
ethics rounds that consist of discussions based on clinical cases and are moderated by an ethicist.
Previous research indicates that the handling of ethically difficult situations in the workplace might
have changed after ethics rounds. This, in turn, would mean that the "ethical climate", i.e. perceptions
of how ethical issues are handled, would have changed. Aim. To investigate whether ethics rounds
could improve the ethical climate perceived by staff working in psychiatry outpatient clinics.
Methods. In this quasi-experimental study, six inter-professional ethics rounds led by a
philosopher/ethicist were conducted at two psychiatry outpatient clinics. Changes in ethical climate
were measured at these clinics as well as at two control clinics at baseline and after the intervention
period using the instrument Hospital Ethical Climate Survey. Results. Within-groups comparisons of
median sum scores of ethical climate showed that no statistically significant differences were found
in the intervention group before or after the intervention period. The median sum scores for ethical
climate were significantly higher, both at baseline and after the intervention period (P = 0.001; P =
0.046), in the intervention group. Conclusions. Ethics rounds in psychiatric outpatient clinics did not
result in significant changes in ethical climate. Outcomes of ethics rounds might, to a higher degree,
be directed towards patient-related outcomes rather than towards the staff's working environment, as
the questions brought up for discussion during the ethics rounds concerned patient-related issues.