Core competencies for clinical ethics committees

Larcher, Vic; Slowther, Anne‐Marie; Watson, Alan R.

doi:10.7861/clinmedicine.10-1-30

Cited by 64 publications

(54 citation statements)

References 15 publications

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“…The spread of CES services internationally shows that the idea of having available some manner of expert ethical support, has clearly taken hold (Aulisio, Arnold, and Youngner, 2000;Gill et al, 2004;Agich, 2005;Royal College of Physicians, 2005;Williamson, McLean, and Connell, 2007;Larcher, Slowther, and Watson, 2010;Dorries et al, 2011). In the next section we will describe some of the major, common features of CES services.…”

Section: The Origins Of Ces Servicesmentioning

confidence: 99%

“…Similarly, accounts of the emergence of CES services point to the technological and social changes that have increased the ethical complexities of patient care (Aulisio, Arnold, and Youngner, 2000;Agich, 2005;Larcher, Slowther, and Watson, 2010). Advances in specialties such as critical care, reproductive medicine, fetal medicine and genetic testing, have led to new treatments that blur important boundaries (e.g., between life and death) and create unprecedented ethical and legal dilemmas around issues such as withdrawing/withholding care.…”

Section: The Origins Of Ces Servicesmentioning

confidence: 99%

“…Three models are currently prevalent: the "ethicist" model of an individual with specialist training in ethics; the "clinical ethics committee" model-a multi-disciplinary group convened on a regular basis; and a small team model, often convened as a sub-group of the larger ethics committee. The individual ethicist model is more prevalent in the United States and Canada, while the committee model appears to be favoured in the UK, Europe and elsewhere (Larcher, Slowther, and Watson, 2010). …”

Section: Functionsmentioning

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: The Origins Of Ces Servicesmentioning

confidence: 99%

Section: Functionsmentioning

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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“…Of course, it is impossible to have a perfect number of members in ECs or a perfect mix of members' characteristics [13,14] but under the umbrella term "multidisciplinary" all the characteristics should be borne in mind to ensure discussions and decisions to encompass different perspectives and experiences, gender included. …”

Section: Discussionmentioning

confidence: 99%

Are the Voices of Women and Men Equally Represented in Ethics Committees? An Italian Survey

Mosconi¹,

Lionello²

2012

J Clinic Res Bioeth

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Introduction: Ethics committees are considered very important in the discussion of ethical questions and clinical research, but little information is available in its representation with respect to the society. World Health Organization stated that the composition of an ethics committee should be representative and balanced.Objective: To describe the proportions of males and females in a sample of 170 Italian ethics committees. Materials and methods:We examined gender distribution in ethics committees by analysis of the data-base available on the institutional free access website of the National Monitoring Centre for Clinical Trials. The findings were compared to a similar sample collected in 2008, and with the percentages of females and males who graduated between 1959-1968 and between 1979-1990, obtained from the National Statistics Institute. Results:In 2010 ethics committees had 69% male and 31% female members. This imbalance only in part reflects the male/female ratio among graduates in the two ranges of years considered. The greatest differences are among medical doctors, with 83% males and 17% females. It contrasts with predominance of women among nurses and volunteers (males 34%, females 66%). Conclusions:We found two kinds of gender imbalance: one among medicine graduates where males predominate and one among nurses and volunteers, with mostly females. This situation is discussed in relation to the representativeness and roles in ethics committees decision making. Progress is needed towards a more equal representation.

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“…[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. 22 According to advocates of CES, it is no longer sufficient in a morally pluralistic world to rely on professional opinion and codes to ensure ethically sound patient care: ethical quality requires ethical expertise.…”

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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Core competencies for clinical ethics committees

Cited by 64 publications

References 15 publications

Clinical Ethics Support in Contemporary Health Care

Clinical Ethics Support in Contemporary Health Care

Are the Voices of Women and Men Equally Represented in Ethics Committees? An Italian Survey

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

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