Paediatrics at the cutting edge: do we need clinical ethics committees?

OBJECTIVES: To investigate the need for hospital clinical ethics committees by studying the frequency with which ethical dilemmas arose, the perceived adequacy of the process of their resolution, and the teaching and training of staff in medical ethics. DESIGN: Interviews with individuals and three...

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Bibliographic Details
Published in:Journal of medical ethics 1997-08, Vol.23 (4), p.245-249
Main Authors: Larcher, V F, Lask, B, McCarthy, J M
Format: Article
Language:English
Subjects:
Bioethics
Care ethics
Child
Clinical ethics
Committee Membership
Decision Making
Ethical aspects
Ethical dilemmas
Ethical instruction
Ethical problems
Ethicists
Ethics committees
Ethics Committees - organization & administration
Ethics Committees, Clinical
Ethics Committees, Research
Ethics Consultation
Ethics, Clinical
Ethics, Medical - education
Evaluation
Guidelines as Topic
Hospitals, Pediatric
Humans
Interdisciplinary Communication
London
Management
Medical ethics
Medical practice
Parental Consent
Pediatrics
Questionnaires
Research ethics
Social Responsibility
Withholding Treatment
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Summary:OBJECTIVES: To investigate the need for hospital clinical ethics committees by studying the frequency with which ethical dilemmas arose, the perceived adequacy of the process of their resolution, and the teaching and training of staff in medical ethics. DESIGN: Interviews with individuals and three multidisciplinary teams; questionnaire to randomly selected individuals. SETTING: Two major London children's hospitals. RESULTS: Ethical dilemmas arose frequently but were resolved in a relatively unstructured fashion. Ethical concerns included: the validity of consent for investigations and treatment; lack of children's involvement in consent; initiation of heroic or futile treatments; resource allocation. Staff expressed the need for a forum which would provide consultation on ethical issues, develop guidelines for good ethical practice, undertake teaching and training, and provide ethical reflection outside the acute clinical setting. CONCLUSION: Multidisciplinary, accountable and audited clinical ethics committees with predominantly advisory, practice development and educational roles could provide a valuable contribution to UK clinical practice and perhaps in other countries that have not developed hospital clinical ethics committees.
ISSN:0306-6800
1473-4257
DOI:10.1136/jme.23.4.245