Development of clinical ethics services in the UK: a national survey
- 1Warwick Medical School, University of Warwick, Coventry, UK
- 2Department of Philosophy, University of South Carolina, Columbia, South Carolina, USA
- 3Department of Public Health Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
- Correspondence to Dr Anne Marie Slowther, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK;
Contributors AMS led the study, obtained funding for the research, contributed to the design and analysis and wrote the final draft of the paper. LM contributed to the design and analysis of the study, was responsible for data collection, wrote the first draft of the paper and contributed to subsequent drafts. CP provided statistical advice and contributed to revised drafts of the paper. AMS is guarantor of the paper.
- Received 12 August 2011
- Revised 14 October 2011
- Accepted 27 October 2011
- Published Online First 13 December 2011
Background In 2001 a report on the provision of clinical ethics support in UK healthcare institutions identified 20 clinical ethics committees. Since then there has been no systematic evaluation or documentation of their work at a national level. Recent national surveys of clinical ethics services in other countries have identified wide variation in practice and scope of activities.
Objective To describe the current provision of ethics support in the UK and its development since 2001.
Method A postal/electronic questionnaire survey administered to the chairs of all 82 clinical ethics services registered with the UK Clinical Ethics Network in July 2010.
Results Response rate was 62% with the majority of responding services situated in acute trusts. All services included a clinical ethics committee with one service also having a clinical ethicist. Lay members were present in 72% of responding committees. Individual case consultation has increased since 2001 with 29% of chairs spending more than 50% of their time on this. Access to and involvement in the process of case consultation is less for patients and families than for clinical staff. There is wide variation in committee processes and levels of institutional support. Over half of the responding committees undertook some form of evaluation.
Conclusion Clinical ethics services in the UK are increasing as is their involvement in case consultation. However, the significant variation in committee processes suggests that further qualitative research is needed to understand how these committees function and the role they play in their institution.
- Clinical ethics committee
- health care survey
- clinical ethics
- resource allocation
- primary care
- applied and professional ethics
- quality of health care
- philosophical ethics
Funding The study was part of a clinical ethics development project funded by the Ethox Foundation. The funding supports a research fellow and research secretary.
Competing interests AMS has been a member of the board of trustees of the UK Clinical Ethics Network since 2001 and is chair of the board with effect from 25 June 2011.
Patient consent The study was a questionnaire survey and responses were anonymous. Return of the form was taken as consent. It is not possible to retrospectively seek consent from individuals and to have obtained individual consent initially would have broken anonymity.
Ethics approval University of Warwick Biomedical Research Ethics Committee.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Further data from the questionnaire survey in relation to questions not covered in this paper are available on request to the corresponding author.