Clinical Ethics Support in Contemporary Health Care

Doran, Evan; Kerridge, Ian; Jordens, Christopher F. C.; Newson, Ainsley J

doi:10.1093/oxfordhb/9780198705109.013.13

Cited by 11 publications

(13 citation statements)

References 92 publications

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“…The integrative CES approach described in this paper bears similarities to, but also differences from, the integrated CES approach developed by the National Center for Ethics in Health Care of the U.S. Department of Veterans Affairs (Fox et al 2010;Doran et al 2016). Both approaches aim to integrate CES into care work processes in response to the shortcomings of traditional CES approaches.…”

Section: Discussionmentioning

confidence: 99%

Integrative Clinical Ethics Support in Gender Affirmative Care: Lessons Learned

et al. 2019

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Clinical ethics support (CES) for health care professionals and patients is increasingly seen as part of good health care. However, there is a key drawback to the way CES services are currently offered. They are often performed as isolated and one-off services whose ownership and impact are unclear. This paper describes the development of an integrative approach to CES at the Center of Expertise and Care for Gender Dysphoria (CEGD) at Amsterdam University Medical Center. We specifically aimed to integrate CES into daily work processes at the CEGD. In this paper, we describe the CES services offered there in detail and elaborate on the 16 lessons we learned from the process of developing an integrative approach to CES. These learning points can inform and inspire CES professionals, who wish to bring about greater integration of CES services into clinical practice.

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Section: Discussionmentioning

confidence: 99%

Integrative Clinical Ethics Support in Gender Affirmative Care: Lessons Learned

et al. 2019

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“…Would primary care services benefit from the aid of a clinical ethics committee (CEC)? While CECs have been established in hospitals in many Western countries, there is little research on CECs in primary care (Doran et al, 2016;Slowther et al, 2004). By "primary care" and "community care" we refer to non-hospital health and social care services provided locally in the community.…”

Section: Introductionmentioning

confidence: 99%

Establishing Clinical Ethics Committees in Primary Care: A Study from Norwegian Municipal Care

2021

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Would primary care services benefit from the aid of a clinical ethics committee (CEC)? The implementation of CECs in primary care in four Norwegian municipalities was supported and their activities followed for 2.5 years. In this study, the CECs’ structure and activities are described, with special emphasis on what characterizes the cases they have discussed. In total, the four CECs discussed 54 cases from primary care services, with the four most common topics being patient autonomy, competence and coercion; professionalism; cooperation and disagreement with next of kin; and priority setting, resource use and quality. Nursing homes and home care were the primary care services most often involved. Next of kin were present in 10 case deliberations, whereas patients were never present. The investigation indicates that it might be feasible for new CECs to attain a high level of activity including case deliberations within the time frame. It also confirms that significant, characteristic and complex moral problems arise in primary care services.

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“…Clinical ethics support services (CESS) aid in the handling of ethical challenges in healthcare. [1][2][3] The clinical ethics committee (CEC) is a kind of CESS which has been established in many hospitals in many Western countries. 4 Nursing homes (residential long-term care), however, are seldom served by CECs.…”

Section: Introductionmentioning

confidence: 99%

Clinical ethics committees in nursing homes: what good can they do? Analysis of a single case consultation

Magelssen¹,

Karlsen

2021

Nurs Ethics

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Background: Ought nursing homes to establish clinical ethics committees (CECs)? An answer to this question must begin with an understanding of how a clinical ethics committee might be beneficial in a nursing home context – to patients, next of kin, professionals, managers, and the institution. With the present article, we aim to contribute to such an understanding. Aim: We ask, in which ways can clinical ethics committees be helpful to stakeholders in a nursing home context? We describe in depth a clinical ethics committee case consultation deemed successful by stakeholders, then reflect on how it was helpful. Research design: Case study using the clinical ethics committee’s written case report and self-evaluation form, and two research interviews, as data. Participants and research context: The nursing home’s ward manager and the patient’s son participated in research interviews. Ethical considerations: Data were collected as part of an implementation study. Clinical ethics committee members and interviewed stakeholders consented to study participation, and also gave specific approval for the publication of the present article. Findings/results: Six different roles played by the clinical ethics committee in the case consultation are described: analyst, advisor, support, moderator, builder of consensus and trust, and disseminator. Discussion: The case study indicates that clinical ethics committees might sometimes be of help to stakeholders in moral challenges in nursing homes. Conclusions: Demanding moral challenges arise in the nursing home setting. More research is needed to examine whether clinical ethics committees might be suitable as ethics support structures in nursing homes and community care.

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Clinical Ethics Support in Contemporary Health Care

Cited by 11 publications

References 92 publications

Integrative Clinical Ethics Support in Gender Affirmative Care: Lessons Learned

Integrative Clinical Ethics Support in Gender Affirmative Care: Lessons Learned

Establishing Clinical Ethics Committees in Primary Care: A Study from Norwegian Municipal Care

Clinical ethics committees in nursing homes: what good can they do? Analysis of a single case consultation

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