Mixed Feelings: Physicians' Concerns About Clinical Ethics Committees in Germany

Dörries, Andrea

doi:10.1023/b:hecf.0000014773.58769.46

Cited by 16 publications

(10 citation statements)

References 16 publications

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“…7 Despite being generally regarded as necessary and helpful, some authors describe possible objections of physicians toward a CEC, including being seen as redundant because ethics are already discussed on the wards and concerns that the CEC might exert pressure on physicians but not take responsibility. 8,9 Nevertheless, these possible objections are not explored empirically.…”

Section: Introductionmentioning

confidence: 99%

Physicians’ and nurses’ expectations and objections toward a clinical ethics committee

et al. 2013

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The study aimed to explore the subjective need of healthcare professionals for ethics consultation, their experience with ethical conflicts, and expectations and objections toward a Clinical Ethics Committee. Staff at a university hospital took part in a survey (January to June 2010) using a questionnaire with open and closed questions. Descriptive data for physicians and nurses (response rate = 13.5%, n = 101) are presented. Physicians and nurses reported similar high frequencies of ethical conflicts but rated the relevance of ethical issues differently. Nurses stated ethical issues as less important to physicians than to themselves. Ethical conflicts were mostly discussed with staff from one's own profession. Respondents predominantly expected the Clinical Ethics Committee to provide competent support. Mostly, nurses feared it might have no influence on clinical practice. Findings suggest that experiences of ethical conflicts might reflect interprofessional communication patterns. Expectations and objections against Clinical Ethics Committees were multifaceted, and should be overcome by providing sufficient information. The Clinical Ethics Committee needs to take different perspectives of professions into account.

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Section: Introductionmentioning

confidence: 99%

Physicians’ and nurses’ expectations and objections toward a clinical ethics committee

et al. 2013

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“…It is noteworthy that the programme attracts physicians (30% of all participants), as they often seem somewhat reluctant about ethics consultation 10 27. Approximately half of the participating physicians come from intensive care units, oncology, palliative care and geriatrics, thus indicating on the one hand where most ethical problems arise and on the other hand where the need for ethical reasoning is most welcome and wanted.…”

Section: Discussionmentioning

confidence: 99%

Implementing clinical ethics in German hospitals: content, didactics and evaluation of a nationwide postgraduate training programme

Dörries¹,

Simon²,

Neitzke

et al. 2010

J Med Ethics

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The Hannover qualifying programme 'ethics consultation in hospitals', conducted by a four-institution cooperation partnership, is an interdisciplinary, scientifically based programme for healthcare professionals interested in ethics consultation services and is widely acknowledged by hospital managements and healthcare professionals. It is unique concerning its content, scope and teaching format. With its basic and advanced modules it has provided training and education for 367 healthcare professionals with 570 participations since 2003 (until February 2010). One characteristic feature is its attractiveness for health professionals from different backgrounds. Internationally, the Hannover programme is one of the few schedules with both academics and non-academics as target groups and a high participation rate of physicians. The concept of the Hannover programme is in great demand, and its schedule is continuously optimised through evaluation. The goals of enabling healthcare professionals from different professional backgrounds to define and reflect ethical problems, to facilitate and support the process of decision-making and to work out structures for their own institutions seem to have been achieved. However, in order to obtain effective and sustainable results, participation in the programme should be supplemented regularly by in-house training sessions or individual expert consultations. Future challenges include new thematic courses and providing a network for former participants, especially when they come from non-academic hospitals. The network is a reasonable platform to discuss participants' experiences, successes and pitfalls. A further task will be research on how the programme's concept can support the sustainability of ethics structures in the various institutions.

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“…In this climate the idea that CECs are unnecessary, that ethics is discussed in hospitals anyway, and that it has always been present in everyday practice, that the majority of ethics issues can be solved or prevented by present legal standards or their improvement and that physicians and hospital staff do not have time for participation in yet another committee are stressed (Dörries 2003).…”

Section: Cecs As ''Alibi Ethics''mentioning

confidence: 99%

Institutional Challenges for Clinical Ethics Committees

Dörries¹,

Boitte

Borovečki

et al. 2011

HEC Forum

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Clinical ethics committees (CECs) have been developing in many countries since the 1980s, more recently in the transitional countries in Eastern Europe. With their increasing profile they are now faced with a range of questions and challenges regarding their position within the health care organizations in which they are situated: Should CECs be independent bodies with a critical role towards institutional management, or should they be an integral part of the hospital organization? In this paper, we discuss the organizational context in which CECs function in Europe focusing on five aspects. We conclude that in Europe clinical ethics committees need to maintain a critical independence while generating acceptance of the CEC and its potential benefit to both individuals and the organization. CECs, perhaps particularly in transitional countries, must counter the charge of "alibi ethics". CECs must define their contribution to in-house quality management in their respective health care organization, clarifying how ethical reflection on various levels serves the hospital and patient care in general. This last challenge is made more difficult by lack of consensus about appropriate quality outcomes for CECs internationally. These are daunting challenges, but the fact that CECs continue to develop suggests that we should make the effort to overcome them. We believe there is a need for further research that specifically addresses some of the institutional challenges facing CECs.

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Mixed Feelings: Physicians' Concerns About Clinical Ethics Committees in Germany

Cited by 16 publications

References 16 publications

Physicians’ and nurses’ expectations and objections toward a clinical ethics committee

Physicians’ and nurses’ expectations and objections toward a clinical ethics committee

Implementing clinical ethics in German hospitals: content, didactics and evaluation of a nationwide postgraduate training programme

Institutional Challenges for Clinical Ethics Committees

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