Table 2 Answers to questions 6–12
Total | n (%) | |
|---|---|---|
6. What are the main ethical doubts or difficulties you encounter in your daily work in the intensive care unit? | 192 | |
a. Withdrawing treatments in end-of-life situations | 23 (12) | |
b. Donation of organs after circulatory death | 38 (20) | |
c. PEG/tracheostomy in patients suffering from chronic-degenerative diseases (e.g., ALS) | 6 (3) | |
d. The “limited” approaches [“skill-limited,” “time-limited,” and “event-limited”] | 12 (6) | |
e. Deep palliative sedation at the end of life | 7 (4) | |
f. The relationship between clinical and research activities | 11 (6) | |
g. The advance directives | 8 (4) | |
h. The communication of “bad news” | 16 (8) | |
i. The conflicts between the care team and the family or between the members of the family itself | 9 (4) | |
j. The differences in diagnostic, therapeutic and prognostic opinions among colleagues | 32 (17) | |
k. The decision to admit a patient to the ICU considering that the resources are not infinite | 30 (16) | |
7. What are your expectations regarding the intervention of the clinical ethicist? | 120 | |
a. The clinical ethicist should be a “facilitator,” helping to analyze the different positions existing among the members of the health team and to find shared solutions to ethical dilemmas | 53 (44) | |
b. The clinical ethicist, when asked, must analyze and offer solutions to the ethical dilemma that a clinical case presents | 16 (13) | |
c. The clinical ethicist must analyze the different possibilities of resolving the case, but without necessarily reaching a single and definitive solution | 16 (13) | |
d. The clinical ethicist can be consulted especially in training/refresher courses for the department in reference to specific clinical cases/contributing to the drafting of guidelines/recommendations | 36 (30) | |
8. At what moment could the presence of the clinical ethicist in the ward be considered most effective? | 73 | |
a. They should be called whenever the need arises | 54 (74) | |
b. It is better to agree on his/her presence on a set day | 1 (1) | |
c. The best time would be during the daily rounds | 14 (20) | |
d. It would be most useful at specific times of the day | 4 (5) | |
9. With whom should the clinical ethicist interface? | 73 | |
a. With the medical coordinator and the director of the Dept. | 0 (0) | |
b. With the doctor requesting the consultation | 1 (1) | |
c. With all the professionals involved in the care of that patient | 16 (22) | |
d. With the healthcare team and, if necessary, also with family members and, where possible, with the patient | 56 (77) | |
10. At what moment could the clinical ethicist be of most help? | 135 | |
a. Mainly in “recommendation for ICU admission” | 32 (24) | |
b. Mainly in “end of life” issues | 57 (42) | |
c. During the rounds | 15 (11) | |
d. During the interview with family members | 30 (22) | |
e. In follow-up visits | 1 (1) | |
11. Before this questionnaire was submitted to you, did you ever think about the need for ethical counselling in the ICU? | 73 | |
a. Often | 29 (40) | |
b. Sometimes | 36 (49) | |
c. Almost never | 3 (4) | |
d. Never | 5 (7) | |
12. At the end of this questionnaire, it is your opinion that the activation of a clinical ethics service for intensive care is: | 73 | |
a. Useless | 0 (0) | |
b. Useful, but not a priority for this ICU, which has more urgent needs | 19 (26) | |
c. Very useful, representing a priority on par with “classic” clinical priorities | 54 (74) |