Clinical ethics consultation in Europe: a comparative and ethical review of the role of patients

Fournier, Véronique; Rari, Eirini; Før­de, Rei­dun; Neitzke, Gerald; Pegoraro, Renzo; Newson, Ainsley J

doi:10.1258/ce.2009.009020

Cited by 44 publications

(43 citation statements)

References 17 publications

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“…A recent survey of clinical ethics committees in the UK showed the number of identified committees to have risen from 20 in 2001 to 82 in 2010 (Slowther, McClimans, and Price, 2012). Clinical ethics networks have also been established in Europe with the European Clinical Ethics Network (Fournier et al, 2009) and in the UK with the United Kingdom Clinical Ethics Network (UKCEN) in an attempt to embed clinical ethics as a core element of health care systems (Slowther, 2008).…”

Section: The Origins Of Ces Servicesmentioning

confidence: 99%

“…Some committees actively educate their members, while others do not or are unable to. Some services involve patients and families directly in their deliberative process and allow them to refer to the service, in many others support is primarily if not exclusively for clinicians (Fournier et al, 2009 Val et al (2001Val et al ( , 2004 and the Royal College of Physicians (2005) show ethics consultations are mostly requested for end-of-life issues, decisions about withdrawing "futile" treatments, and late-term abortions. Other frequently occurring issues include disagreement among clinicians, professional misconduct, and concerns related to truthtelling and confidentiality.…”

Section: Evaluation Of Ces Servicesmentioning

confidence: 99%

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Clinical Ethics Support in Contemporary Health Care

Doran¹,

Kerridge²,

Jordens³

et al. 2016

Oxford Handbooks Online

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This chapter discusses clinical ethics support services (CES Services), the development of which has arisen to help respond to ethical issues arising in health care settings. CES services are comprised of an individual or group, usually in an organization, who can provide a suite of services to support all stakeholders in identifying and managing ethical issues they face. While there is a degree of consensus about the potential value of such services, they are also the focus of ongoing theoretical, methodological and political debates. The aim of this chapter is to provide health care managers with an account of how and why CES services are becoming a part of the contemporary organizational landscape of health care, and describe the concerns that bioethicists and others have raised regarding their role, function and dissemination.

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Section: The Origins Of Ces Servicesmentioning

confidence: 99%

Section: Evaluation Of Ces Servicesmentioning

confidence: 99%

Clinical Ethics Support in Contemporary Health Care

Doran¹,

Kerridge²,

Jordens³

et al. 2016

Oxford Handbooks Online

View full text Add to dashboard Cite

show abstract

“…8 In Europe, there is similar interest and discussion about the potential role and outcomes of clinical ethics consultations. 23 In Australia, as in the UK, Clinical Ethics Committees are not mandated by government accreditation processes, although there is growing interest in their development. In 2000, McNeil 24 reported that there were roughly 120 Clinical Ethics Committees in operation, representing between 10 and 20% of hospitals surveyed.…”

Section: Introductionmentioning

confidence: 99%

The role of clinical ethics consultations for physical therapy practice

Delany

2012

Physical Therapy Reviews

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Background and purpose: As autonomous practitioners, and as part of multidisciplinary health teams, physical therapists encounter unique and complex ethical challenges. Frameworks and models of ethical decision-making have been developed to assist therapists to integrate ethical theory and principles with the needs, experiences, and opportunities of their patients and patient communities. However, there is little in the way of clinically based courses and practical approaches to assist physical therapists to recognize and respond to the ethical issues that they encounter in their everyday practice.Objectives: This paper proposes clinical ethics consultations as a practical mechanism to assist physical therapists to identify and negotiate the ethical dimensions of their everyday practice. Clinical ethics consultations aim to resolve conflict, facilitate communication, and ease moral distress in health care. The strategies used are to identify common ground between differing values expressed, use questions to examine harms and benefits of clinical actions, and model approaches for thinking about and framing ethical challenges and facilitating participants to see their own positions relative to others. Three narratives highlighting ethical issues in physical therapy clinical practice are used to demonstrate how a clinical ethics consultation might provide a structured exploration of ethical issues. Conclusions: To develop capacity for moral action in everyday practice, therapists need skills in clarifying their ethical values and professional moral obligations and ultimately, to make decisions which are in the best interests of their patients. Clinical ethics consultations are one way to advance this area of professional practice.

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“…[3][4][5] CES services are an established feature of healthcare in the US and Canada and are becoming so in the UK and elsewhere in Europe and Asia. [6][7][8][9][10][11][12][13][14][15][16][17][18] The growth of such services internationally is often taken to indicate a growing perceived need among clinicians for assistance with the many ethical and legal issues they face. [14][15][16][17] Although clinicians have always faced complex ethical decisions, the need for CES is driven by factors that have increased the ethical complexities of patient care, such as greater social and value plurality, technological advances and heightened patient autonomy.…”

Section: Introductionmentioning

confidence: 99%

“…[6][7][8][9][10][11][12][13][14][15][16][17][18] The growth of such services internationally is often taken to indicate a growing perceived need among clinicians for assistance with the many ethical and legal issues they face. [14][15][16][17] Although clinicians have always faced complex ethical decisions, the need for CES is driven by factors that have increased the ethical complexities of patient care, such as greater social and value plurality, technological advances and heightened patient autonomy. [19][20][21] Clinicians have traditionally dealt with ethical issues by keeping their own counsel, turning to trusted colleagues or professional codes of ethics or seeking guidance from religious authorities.…”

Section: Introductionmentioning

confidence: 99%

Managing ethical issues in patient care and the need for clinical ethics support

Doran¹,

Fleming²,

Jordens³

et al. 2015

Aust. Health Review

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Objective. To investigate the range, frequency and management of ethical issues encountered by clinicians working in hospitals in New South Wales (NSW), Australia.Methods. A cross-sectional survey was conducted of a convenience sample of 104 medical, nursing and allied health professionals in two NSW hospitals.Results. Some respondents did not provide data for some questions, therefore the denominator is less than 105 for some items. Sixty-two (62/104; 60%) respondents reported occasionally to often having ethical concerns. Forty-six (46/105; 44%) reported often to occasionally having legal concerns. The three most common responses to concerns were: talking to colleagues (96/105; 91%); raising the issue in a group forum (68/105; 65%); and consulting a relevant guideline (64/105; 61%). Most respondents were highly (65/99; 66%) or moderately (33/99; 33%) satisfied with the ethical environment of the hospital. Twenty-two (22/98; 22%) were highly satisfied with the ethical environment of their department and 74 (74/98; 76%) were moderately satisfied. Most (72/105; 69%) respondents indicated that additional support in dealing with ethical issues would be helpful.Conclusion. Clinicians reported frequently experiencing ethical and legal uncertainty and concern. They usually managed this by talking with colleagues. Although this approach was considered adequate, and the ethics of their hospital was reported to be satisfactory, most respondents indicated that additional assistance with ethical and legal concerns would be helpful. Clinical ethics support should be a priority of public hospitals in NSW and elsewhere in Australia.

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Clinical ethics consultation in Europe: a comparative and ethical review of the role of patients

Cited by 44 publications

References 17 publications

Clinical Ethics Support in Contemporary Health Care

Clinical Ethics Support in Contemporary Health Care

The role of clinical ethics consultations for physical therapy practice

Managing ethical issues in patient care and the need for clinical ethics support

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