Can I trust them to do everything? The role of distrust in ethics committee consultations for conflict over life-sustaining treatment among Afro-Caribbean patients
BackgroundDistrust in the American healthcare system is common among Afro-Caribbeans but the role of this distrust in conflict over life-sustaining treatment is not well described.ObjectiveTo identify the ways that distrust manifests in ethics committee consultation for conflict over life-sustaining...
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| Veröffentlicht in: | Journal of medical ethics 2016-09, Vol.42 (9), p.582-585 |
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| creator | Romain, Frederic Courtwright, Andrew |
| description | BackgroundDistrust in the American healthcare system is common among Afro-Caribbeans but the role of this distrust in conflict over life-sustaining treatment is not well described.ObjectiveTo identify the ways that distrust manifests in ethics committee consultation for conflict over life-sustaining treatment among Afro-Caribbean patients.MethodsThis was a retrospective cohort study at a large academic hospital of all ethics committee consultations for life-sustaining treatment among Afro-Caribbean patients and their surrogates. We reviewed medical records and identified cases in which ethics consultants described distrust as playing a role in the conflict over life-sustaining treatment.ResultsOf the 169 ethics committee consultation cases for conflict over life-sustaining treatment, 11 (6.5%) involved patients who self-identified as Afro-Caribbean. Distrust played a role in several of these cases, with surrogates of three patients, in particular, illustrating the way that perceived heath disparities, past labelling and concerns about continued maltreatment generated distrust leading to conflict over life-sustaining treatment.ConclusionsExploring issues of distrust may help ethics consultants identify the source of conflict over life-sustaining treatment among Afro-Caribbean patients. |
| doi_str_mv | 10.1136/medethics-2015-103137 |
| format | Article |
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The role of distrust in ethics committee consultations for conflict over life-sustaining treatment among Afro-Caribbean patients</title><source>Jstor Complete Legacy</source><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><creator>Romain, Frederic ; Courtwright, Andrew</creator><creatorcontrib>Romain, Frederic ; Courtwright, Andrew</creatorcontrib><description>BackgroundDistrust in the American healthcare system is common among Afro-Caribbeans but the role of this distrust in conflict over life-sustaining treatment is not well described.ObjectiveTo identify the ways that distrust manifests in ethics committee consultation for conflict over life-sustaining treatment among Afro-Caribbean patients.MethodsThis was a retrospective cohort study at a large academic hospital of all ethics committee consultations for life-sustaining treatment among Afro-Caribbean patients and their surrogates. We reviewed medical records and identified cases in which ethics consultants described distrust as playing a role in the conflict over life-sustaining treatment.ResultsOf the 169 ethics committee consultation cases for conflict over life-sustaining treatment, 11 (6.5%) involved patients who self-identified as Afro-Caribbean. Distrust played a role in several of these cases, with surrogates of three patients, in particular, illustrating the way that perceived heath disparities, past labelling and concerns about continued maltreatment generated distrust leading to conflict over life-sustaining treatment.ConclusionsExploring issues of distrust may help ethics consultants identify the source of conflict over life-sustaining treatment among Afro-Caribbean patients.</description><identifier>ISSN: 0306-6800</identifier><identifier>EISSN: 1473-4257</identifier><identifier>DOI: 10.1136/medethics-2015-103137</identifier><identifier>PMID: 27178534</identifier><identifier>CODEN: JMETDR</identifier><language>eng</language><publisher>England: BMJ</publisher><subject>African Americans ; Afro-Caribbeans ; Attitude of Health Personnel ; Bioethics ; Case-Control Studies ; Conflict of Interest ; Consultants ; Critical Care - ethics ; Critical Care - standards ; Decision making ; Decision Making, Organizational ; Ethical aspects ; Ethics ; Ethics Committees ; Ethics Consultation - statistics & numerical data ; Ethnic Groups ; Health aspects ; Health Status Disparities ; Hemodialysis ; Humans ; Medical Futility - ethics ; Minority & ethnic groups ; Ostomy ; Palliative care ; Patients ; Physicians ; Practice ; Racism - ethics ; Racism - statistics & numerical data ; Substance abuse treatment ; Terminal care ; Trust ; United States - epidemiology</subject><ispartof>Journal of medical ethics, 2016-09, Vol.42 (9), p.582-585</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing</rights><rights>Copyright: 2016 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b438t-2ac407c2ca2f9128866a7348a3cf377ef19085aa50ee233baca8c440244986e23</citedby><cites>FETCH-LOGICAL-b438t-2ac407c2ca2f9128866a7348a3cf377ef19085aa50ee233baca8c440244986e23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jme.bmj.com/content/42/9/582.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttps://jme.bmj.com/content/42/9/582.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,776,780,799,3183,23550,27901,27902,57992,58225,77342,77373</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27178534$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Romain, Frederic</creatorcontrib><creatorcontrib>Courtwright, Andrew</creatorcontrib><title>Can I trust them to do everything? The role of distrust in ethics committee consultations for conflict over life-sustaining treatment among Afro-Caribbean patients</title><title>Journal of medical ethics</title><addtitle>J Med Ethics</addtitle><description>BackgroundDistrust in the American healthcare system is common among Afro-Caribbeans but the role of this distrust in conflict over life-sustaining treatment is not well described.ObjectiveTo identify the ways that distrust manifests in ethics committee consultation for conflict over life-sustaining treatment among Afro-Caribbean patients.MethodsThis was a retrospective cohort study at a large academic hospital of all ethics committee consultations for life-sustaining treatment among Afro-Caribbean patients and their surrogates. We reviewed medical records and identified cases in which ethics consultants described distrust as playing a role in the conflict over life-sustaining treatment.ResultsOf the 169 ethics committee consultation cases for conflict over life-sustaining treatment, 11 (6.5%) involved patients who self-identified as Afro-Caribbean. Distrust played a role in several of these cases, with surrogates of three patients, in particular, illustrating the way that perceived heath disparities, past labelling and concerns about continued maltreatment generated distrust leading to conflict over life-sustaining treatment.ConclusionsExploring issues of distrust may help ethics consultants identify the source of conflict over life-sustaining treatment among Afro-Caribbean patients.</description><subject>African Americans</subject><subject>Afro-Caribbeans</subject><subject>Attitude of Health Personnel</subject><subject>Bioethics</subject><subject>Case-Control Studies</subject><subject>Conflict of Interest</subject><subject>Consultants</subject><subject>Critical Care - ethics</subject><subject>Critical Care - standards</subject><subject>Decision making</subject><subject>Decision Making, Organizational</subject><subject>Ethical aspects</subject><subject>Ethics</subject><subject>Ethics Committees</subject><subject>Ethics Consultation - statistics & numerical data</subject><subject>Ethnic Groups</subject><subject>Health aspects</subject><subject>Health Status Disparities</subject><subject>Hemodialysis</subject><subject>Humans</subject><subject>Medical Futility - ethics</subject><subject>Minority & ethnic groups</subject><subject>Ostomy</subject><subject>Palliative care</subject><subject>Patients</subject><subject>Physicians</subject><subject>Practice</subject><subject>Racism - ethics</subject><subject>Racism - statistics & numerical data</subject><subject>Substance abuse treatment</subject><subject>Terminal care</subject><subject>Trust</subject><subject>United States - epidemiology</subject><issn>0306-6800</issn><issn>1473-4257</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>AVQMV</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>K50</sourceid><sourceid>M1D</sourceid><sourceid>M2O</sourceid><recordid>eNqNkctu1DAUhiMEokPhEYossWET8C2xs0KjEZdKlbopa8vxnMx45MSD7aD2eXhRTpRSJFZ448v5zn9--a-qK0Y_MCbajyPsoRy9yzWnrKkZFUyoZ9WGSSVqyRv1vNpQQdu61ZReVK9yPlFcXHcvqwuumNKNkJvq185O5JqUNOdCyhFGUiLZRwI_IT2g_nT4RO6OQFIMQOJA9j6vrJ_IOp-4OI6-FAA8TXkOxRaPBzLEtLwMwbtCIuqR4AeoM3ZbP6EyTgVbRpgKsWPE-3ZIsd7Z5Pse0NYZhbCYX1cvBhsyvHncL6vvXz7f7b7VN7dfr3fbm7qXQpeaWyepctxZPnSMa922VgmprXCDUAoG1lHdWNtQAC5Eb53VTkrKpex0i0-X1ftV95zijxlyMaPPDkKwE8Q5G6aZbBstRIPou3_QU5zThO4Wquk05UogVa_UwQYwfsLfKHBfXAwBDmDQ_O7WbGXbaakZWww0K-9SzDnBYM7JjzY9GEbNkrp5St0sqZs1dex7--hm7pF46voTMwJXK3DKJaa_9VZp0dGlTtd6P57-c-ZvOczFbA</recordid><startdate>201609</startdate><enddate>201609</enddate><creator>Romain, Frederic</creator><creator>Courtwright, Andrew</creator><general>BMJ</general><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group LTD</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>88J</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>AABKS</scope><scope>ABSDQ</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AVQMV</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K50</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1D</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>M2R</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>201609</creationdate><title>Can I trust them to do everything? The role of distrust in ethics committee consultations for conflict over life-sustaining treatment among Afro-Caribbean patients</title><author>Romain, Frederic ; Courtwright, Andrew</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b438t-2ac407c2ca2f9128866a7348a3cf377ef19085aa50ee233baca8c440244986e23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>African Americans</topic><topic>Afro-Caribbeans</topic><topic>Attitude of Health Personnel</topic><topic>Bioethics</topic><topic>Case-Control Studies</topic><topic>Conflict of Interest</topic><topic>Consultants</topic><topic>Critical Care - ethics</topic><topic>Critical Care - standards</topic><topic>Decision making</topic><topic>Decision Making, Organizational</topic><topic>Ethical aspects</topic><topic>Ethics</topic><topic>Ethics Committees</topic><topic>Ethics Consultation - statistics & numerical data</topic><topic>Ethnic Groups</topic><topic>Health aspects</topic><topic>Health Status Disparities</topic><topic>Hemodialysis</topic><topic>Humans</topic><topic>Medical Futility - ethics</topic><topic>Minority & ethnic groups</topic><topic>Ostomy</topic><topic>Palliative care</topic><topic>Patients</topic><topic>Physicians</topic><topic>Practice</topic><topic>Racism - ethics</topic><topic>Racism - statistics & numerical data</topic><topic>Substance abuse treatment</topic><topic>Terminal care</topic><topic>Trust</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Romain, Frederic</creatorcontrib><creatorcontrib>Courtwright, Andrew</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>Philosophy Collection</collection><collection>Philosophy Database</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>Arts Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>Art, Design & Architecture Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Arts & Humanities Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Social Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of medical ethics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Romain, Frederic</au><au>Courtwright, Andrew</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Can I trust them to do everything? The role of distrust in ethics committee consultations for conflict over life-sustaining treatment among Afro-Caribbean patients</atitle><jtitle>Journal of medical ethics</jtitle><addtitle>J Med Ethics</addtitle><date>2016-09</date><risdate>2016</risdate><volume>42</volume><issue>9</issue><spage>582</spage><epage>585</epage><pages>582-585</pages><issn>0306-6800</issn><eissn>1473-4257</eissn><coden>JMETDR</coden><abstract>BackgroundDistrust in the American healthcare system is common among Afro-Caribbeans but the role of this distrust in conflict over life-sustaining treatment is not well described.ObjectiveTo identify the ways that distrust manifests in ethics committee consultation for conflict over life-sustaining treatment among Afro-Caribbean patients.MethodsThis was a retrospective cohort study at a large academic hospital of all ethics committee consultations for life-sustaining treatment among Afro-Caribbean patients and their surrogates. We reviewed medical records and identified cases in which ethics consultants described distrust as playing a role in the conflict over life-sustaining treatment.ResultsOf the 169 ethics committee consultation cases for conflict over life-sustaining treatment, 11 (6.5%) involved patients who self-identified as Afro-Caribbean. Distrust played a role in several of these cases, with surrogates of three patients, in particular, illustrating the way that perceived heath disparities, past labelling and concerns about continued maltreatment generated distrust leading to conflict over life-sustaining treatment.ConclusionsExploring issues of distrust may help ethics consultants identify the source of conflict over life-sustaining treatment among Afro-Caribbean patients.</abstract><cop>England</cop><pub>BMJ</pub><pmid>27178534</pmid><doi>10.1136/medethics-2015-103137</doi><tpages>4</tpages></addata></record> |
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| source | Jstor Complete Legacy; MEDLINE; BMJ Journals - NESLi2 |
| subjects | African Americans Afro-Caribbeans Attitude of Health Personnel Bioethics Case-Control Studies Conflict of Interest Consultants Critical Care - ethics Critical Care - standards Decision making Decision Making, Organizational Ethical aspects Ethics Ethics Committees Ethics Consultation - statistics & numerical data Ethnic Groups Health aspects Health Status Disparities Hemodialysis Humans Medical Futility - ethics Minority & ethnic groups Ostomy Palliative care Patients Physicians Practice Racism - ethics Racism - statistics & numerical data Substance abuse treatment Terminal care Trust United States - epidemiology |
| title | Can I trust them to do everything? The role of distrust in ethics committee consultations for conflict over life-sustaining treatment among Afro-Caribbean patients |
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