Table 6 The #1 greatest challenges faced by health care ethics programs (HCEPs) (N = 232)

Resource shortages (time, money, staff, recruitment, and training)

Lack of time and training of some committee members, especially the physician members

As awareness about our services grows the demand grows too, but without additional financial support we are unable to meet the demand. Additionally, while we have targeted known high-need areas, without further financial support we are unable to educate the institution more broadly or assess needs and develop initiatives to target other areas

Not enough hours in the day/personnel to be present across the house

Underutilization of HCEP services

Lack of interest in ethics unless it is to back up a doctor who is making a difficult decision. There is a sense that attendings don't know why an ethics consultant would ever question an attending's decision, even though attendings don't always see how ethically complicated a decision might be

Other

Relationship building

Making ethics a priority alongside issues of improving quality metrics

Lack of clarity about the HCEP’s goals or purpose

Defining/delineating scope with overlapping services (e.g., social work, palliative care)

Clarification between clinical bioethics and “ethics and compliance (ECO)" related issues

Lack of support for the HCEP from organizational leadership

For me, it is the notion of buy in, whether financially, personnel resourcing, commitment from Senior Leadership. Currently, Healthcare Ethics at our Institution seems to be viewed as “oh it's nice to have, but we're not going to commit the resources to really developing and strengthening it.”