The Impact on Clinical Practice

Relatively few studies have looked at the impact of the bioethics movement on clinical practices. One series of studies looked at the impact of New York’s 1987 law establishing formal policies for writing “don’t resuscitate” orders (orders forbidding health care workers from intervening if the lungs or heart of a terminally ill patient stops functioning). These studies found that after the law’s passage, doctors significantly altered how they documented their actions but not how they acted. Similarly, studies have found that hospitals sharply limit access of patients, family, and nonmedical staff to ethics consul- tations. As a result, consultations primarily function to provide additional institutional support to doctors confronted by families or patients they consider disruptive, such as those who challenge doctors’ decisions regarding how aggressively to treat a patient. These findings have led researchers to conclude that the true purpose of ethics consultations is to reinforce doctors’ power.