Mapping the Landscape of Pediatric Clinical Ethics Consults: A Systematic Scoping Review Protocol

Background Clinical ethics consultation (CEC) services aim to improve the quality and delivery of healthcare by identifying, evaluating, and resolving ethical questions. Approximately one third of children’s hospitals lack CEC services, although this number has increased over the past decade. While there is robust literature on the characteristics, processes, and outcomes of adult CECs, the extent and nature of literature describing pediatric CECs remains unknown. The objective of this systematic scoping review is to map literature that quantifies and characterizes pediatric CECs.

This review will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews Guidelines (PRISMA-ScR). Inclusion criteria include studies that quantify and characterize pediatric CECs. We will exclude non-English language publications, nonhuman studies, studies that center on maternal-fetal cases, reviews, dissertations, book chapters, and guideline or consensus statements. PubMed, EMBASE, Web of Science, and CINAHL will be searched using a strategy developed by an experienced research librarian. References will be managed in EndNote X9. Title/abstract screening and full text review will be performed using Covidence. Data will be presented in tabular and narrative form.

Improved understanding of the characteristics, patterns, and trends in pediatric CECs may identify unique and unmet pediatric ethical needs. Identifying these needs may present opportunities to inform initiatives in pediatric ethics program building, education, and research. As research in pediatric clinical ethics evolves, it is also critical to identify the relative strengths and limitations of existing process and outcome typologies, given that there is no universal standard. Competing Interest Statement The authors have declared no competing interest. Funding Statement This study did not receive any funding Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability All data produced in the present work are contained in the manuscript Abbreviations - AMA - American Medical Association - ASBH - American Society for Bioethics and Humanities - CEC - Clinical Ethics Consultation - PRISMA-ScR - Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews Guidelines