Is the discussion of patient cases in clinical ethics-committees useful?
BACKGROUND
All health enterprises in Norway today have at least one clinical ethics committee (CEC). One of the aims is to give advice and to counsel the hospital staff on ethical issues. As part of the quality assurance of this work, we wanted to find out if clinicians have benefited from these committees in individual cases.


METHODS
The local committees were requested to distribute a questionnaire to all clinicians who had submitted a case to the committee during the previous 18 months. The survey was anonymous. Out of the 86 questionnaires that were distributed, 43 (50%) were returned to the Centre for Medical Ethics.


RESULTS
The majority of clinicians had a number of reasons for contacting the committee. The most usual reason was the desire to have a broad consultation on a case (70%), which was regarded as useful. The most common issue discussed was limiting the treatment of a seriously ill patient (56%), the will/wishes of the next-of-kin (40%) and patient autonomy (37%). The committee gave advice in 50% of the cases. Thirty-eight percent of the consultations resulted in practical consequences, including the discontinuation of treatment in six cases.


CONCLUSIONS
Because of the low response percentage, the results must be interpreted with caution. The work of the committees is generally evaluated as useful, and the consultations can have practical consequences. However, it is challenging to make this work better known among clinicians and to conduct quality assurance.
Centre for Medical Ethics, University of Oslo, Postbox 1130 Blindern, 0318 Oslo, Norway.
Guro
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Kalager
Reidun
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Førde
Reidar
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Pedersen
D003142:Communication; D003220:Conflict, Psychological; D028741:Ethics Committees, Clinical / Q000592:standards / Q000706:statistics & numerical data; D033061:Ethics Consultation; D026690:Ethics, Clinical; D006801:Humans; D009664:Norway; D010358:Patient Participation; D011785:Quality Assurance, Health Care; D011795:Surveys and Questionnaires