Er drøftingen av pasientsaker i kliniske etikk-komiteer nyttig?

Abstract

Background: Today all Norwegian hospital trusts have at least one clinical ethics committee (CEC). Part of their mandate is to give advice and guide hospital clinicians in ethically challenging situations. We wanted to find out if clinicians who had used CEC in situations regarding individual patients found it useful and worthwhile doing. Material and methods: The local CECs were asked to forward a questionnaire to all clinicians who had discussed an individual patient case in a CEC during the foregoing 18 months. The survey was anonymous. 43 out of 86 questionnaires (50 %) were returned. Results: Most clinicians gave several reasons for contacting CEC, most common was the wish to get a broad discussion of the case. They found the deliberation to be very useful in this case. Ethical challenges related to foregoing of medical treatment for seriously ill patients (56%), relative`s will (40%) and patient autonomy (37%) were most frequently discussed. CEC gave an advice in 50% of the cases, and 38% of the deliberations had practical consequences, for example foregoing of medical treatment in six cases. Interpretation: CEC discussions influence complicated decision-making processes. The committee-work is mostly evaluated as useful, and the deliberations often have practical consequences. A future challenge is to make CEC well known among clinicians and secure good quality.