A report on small team clinical ethics consultation programmes in Japan: Table 1

Abstract

Clinical ethics support, including ethics consultation, has become established in the field of medical practice throughout the world. This practice has been regarded as useful, most notably in the UK and the USA, in solving ethical problems encountered by both medical practitioners and those who receive medical treatment. In Japan, however, few services are available to respond to everyday clinical ethical issues, although a variety of difficult ethical problems arise daily in the medical field: termination of life support, euthanasia and questions about patient autonomy. In light of these conditions, a group of 17 volunteer educators and researchers from the area of biomedical ethics, including the authors, have formed the Clinical Ethics Support and Education Project, and began providing Japan's first small team clinical ethics consultation service in October, 2006. Members include scholars of biomedical ethics, scholars of philosophy and ethics, legal professionals and legal scholars, nurses and doctors, consisting of five women and 12 men. Consultation teams, made up of a small number of members, were organised each time a request for consultation was received. Over approximately 15 months (October 2006-December 2007), the programme received 22 consultation requests from medical practitioners and medical institutions, and three from the families of patients. In this paper, we will discuss the status of our consultation service and examples of consultation cases we have handled. In addition, we will examine the process of evaluating small team clinical ethics consultation services, as well as the strengths and weakness of such programmes.

Proposal for a Hospital Ethics Committee at the Hacettepe University Hospitals, Turkey: A Mixed Method Study

“…In a research published in 2008 within the scope of a project, 17 educators working in biomedical ethics field have conducted a clinical ethics and support activity. The results obtained from the review of the one-year activity of consultancy service carried out by this small group which was considered as the first application in this field were found positive (7). In Norway example on the other hand, Ethics Center started a project in 1993 with the support of Ministry of Health.…”

Ethical difficulties in nursing, educational needs and attitudes about using ethics resources

“…2 In particular, the limited availability of ethics consultation services, which has been reported by authors from different countries, fails to meet the frequent and strong requests by health workers to support their ethical difficulties in situations involving the terminally ill, patient autonomy and end-of-life decisions. 7 The delay of institutions in providing ethics consultation services is only one aspect of the inadequacy of the response to the increasing ethical difficulties in care activities. While ethical issues are present in many health school programmes, several studies highlight how basic and lifetime learning in ethics are poorly diffused among healthcare workers.…”

To evaluate the effectiveness of health care ethics consultation based on the goals of health care ethics consultation: a prospective cohort study with randomization

“…In 2008, Fukuyama et al reported the first small team HCEC services started in October 2006 in Japan, which was also the first formal HCEC published in an academic international journal from East Asia [19]. Until now, there is no formal report published in academic international journals regarding HCEC services in the health care institutions in Taiwan.…”