The primary objective was to review pediatric ethics consultations (PECs) at a large academic health center over a nine year period, assessing demographics, ethical issues, and consultant intervention. The secondary objective was to describe the evolution of PECs at our institution. This was a retrospective review of Consultation Summary Sheets compiled for PECs at our Academic Health Center between January 2008 and April 2017. There were 165 PECs reviewed during the study period. Most consult requests came from the inpatient setting, with the Pediatric and Neonatal Intensive Care Units being the highest utilizers. Consultation utilization increased over the study period. The most common patient age was less than one year. Physicians were most likely to request consultation. Patient Best Interest, Withholding/Withdrawing of Life Sustaining Therapy, and Provider Moral Distress were ethical issues most commonly identified by the consultants. Making recommendations was the most common consultant intervention. The ethics consultation process evolved over time from informal provider discussions, to a hospital infant care review committee, to a pediatric only consultation service, to a combined adult/pediatric consultation service, with variable levels of salary support for consultants. Ethics consultation requests are growing at our institution. Similarities in identified ethical issues exist between our findings and existing literature, however meaningful comparisons remains elusive secondary to variability in approaches to investigation and reporting. A combined paid/volunteer/trainee ethics consultation service model appears sustainable and real time ethics consultation is feasible using this approach.

中文翻译：

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大型学术中心儿科伦理咨询服务的发展与回顾

主要目标是回顾大型学术健康中心 9 年来的儿科伦理咨询 (PEC)，评估人口统计学、伦理问题和顾问干预。第二个目标是描述我们机构 PEC 的演变。这是对 2008 年 1 月至 2017 年 4 月在我们的学术健康中心为 PEC 编制的咨询摘要表的回顾性审查。在研究期间审查了 165 个 PEC。大多数咨询请求来自住院环境，儿科和新生儿重症监护病房是使用率最高的。在研究期间，咨询使用率有所增加。最常见的患者年龄不到一岁。医生最有可能要求会诊。患者最大利益，暂停/撤回生命维持治疗，和提供者道德困境是顾问最常发现的道德问题。提出建议是最常见的顾问干预。随着时间的推移，伦理咨询过程从非正式的提供者讨论演变为医院婴儿护理审查委员会，再到仅限儿科的咨询服务，再到成人/儿科联合咨询服务，为顾问提供不同水平的薪酬支持。我们机构的道德咨询请求越来越多。我们的发现与现有文献之间在已确定的伦理问题上存在相似之处，但由于调查和报告方法的可变性，有意义的比较仍然难以实现。