[Foundation of a Health Care Ethics Committee (HEC) in a nonconfessional hospital. Initial experiences and prospects of the future].
BACKGROUND
Whereas Health Care Ethics Committees (HECs) are well established in the USA, they are still an exception in Germany. In this study, the authors report of the implementation of an HEC at the SLK Hospital Heilbronn, Germany, and discuss the further development within the first 2 years.
After a 1-year preparatory period the official establishment of the HEC followed in March 2004. The hospital management was implicated in the implementation from the beginning. 17 HEC members were recruited proportionally to the own four hospital locations. An ethics forum existing besides the HEC represents an institution open to all clinic employees. After training of moderators with a specially developed training concept, an individual case consultation was established. In a next step, working groups were founded for the projects "advance directive", "dying in hospital", "limitation of treatment" and "patient advocate" in order to develop guidelines. Education in ethics is offered in the ethics forum.


CONCLUSIONS
This report elucidates that a great readiness of committee members and a tight integration of the clinic management are essential for a successful establishment of an HEC. The structure converted within the authors' HEC permits a discussion of ethical problems beyond existing hierarchies and occupational groups. In this new institution the authors see a great potential for improvement in dealing with ethical problems within the hospital.
Scheffold
Norbert
N
Medizinische Klinik I, SLK-Kliniken Heilbronn GmbH, Klinikum am Gesundbrunnen, Heilbronn. Norbert.Scheffold@Klinikum-Heilbronn.de
Paoli
Adriano
A
Kern
Mechthild
M
Böhringer
Silvia
S
Berentelg
Johannes
J
Cyran
Joachim
J
D016223:Advance Directives / Q000941:ethics; D028741:Ethics Committees, Clinical / Q000458:organization & administration* / Q000639:trends; D005858:Germany; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration; D010166:Palliative Care / Q000941:ethics; D010344:Patient Advocacy / Q000941:ethics; D012017:Referral and Consultation / Q000458:organization & administration; D013727:Terminal Care / Q000941:ethics