title: Clinical Bioethics Committees: a Brazilian experience.
abstract: Since its beginning, Bioethics has been related to medical decision making. In health settings, difficult dilemmas, critical situations, controversial decisions are problems that clinical Bioethics reflects on. Institutional Ethics Committees is a general and ambiguous denomination to many different activities. In Brazilian hospitals, we have three different kinds of ethics and bioethics committees: Medical Ethics Committees, Research Ethics Committees and Clinical Bioethics Committees. The first implemented committees were the Medical Ethics Committees, whose objective is to evaluate professional ethics conflicts. These committees were proposed by the Conselho Federal de Medicina (Brazilian Medicine Council). In 1988, the Brazilian government, through the Conselho Nacional de Saude (Brazilian National Health Council) proposed the first research guidelines: Resolucao 01/88, updated in 1996 by Resolucao 196/96. One of these guidelines created the Research Ethics Committees. The first one was created in the Hospital Sao Lucas and the second in the Hospital de Clinicas de Porto Alegre, both in Porto Alegre, Rio Grande do Sul. In 1993, the Hospital de Clinicas de Porto Alegre created the first Brazilian Clinical Bioethics Committee. A Clinical Bioethics Committee can be defined as an interdisciplinary group of health professionals and other persons, whose objective is to provide consultancy on ethical questions and suggest institutional ethical guidelines, in a transdisciplinary perspective. In healthcare institutions, especially in hospitals, Clinical Bioethics Committees can help different segments in critical decision-making that involves ethical, moral, legal or social issues. The activities of a Clinical Bioethics Committee can be reactive or proactive. Consultancy is the typical reactive activity. Clinical Bioethics rounds are the example of proactive activity. In this study, we will present two different Brazilian experiences in Clinical Bioethics Committees: Hospital Sao Lucas and Hospital de Clinicas de Porto Alegre.
authors.affiliation: Bioethics and Science Ethics Research Laboratory of the Hospital de Clínicas de Porto Alegre.
authors.forename: Josté Roberto
authors.initials: JR
authors.lastname: Goldim
authors.forename: Márcia M
authors.initials: MM
authors.lastname: Raymundo
authors.forename: Márcia Santana
authors.initials: MS
authors.lastname: Fernandes
authors.forename: Maria Helena Itaqui
authors.initials: MH
authors.lastname: Lopes
authors.forename: Délio José
authors.initials: DJ
authors.lastname: Kipper
authors.forename: Carlos Fernando
authors.initials: CF
authors.lastname: Francisconi
mesh_terms: D026688:Bioethical Issues; D001938:Brazil; D026689:Ethical Analysis; D028741:Ethics Committees, Clinical / Q000941:ethics / Q000458:organization & administration*; D026690:Ethics, Clinical; D006801:Humans; D009937:Organizational Objectives; D010344:Patient Advocacy / Q000941:ethics*; D028662:Principle-Based Ethics; D011361:Professional Competence; D024382:Professional Role