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Clinical ethics protocols in the clinical ethics committees of Madrid
  1. Benjamin Herreros1,
  2. Venktesh R Ramnath2,
  3. Laura Bishop3,
  4. Emilio Pintor1,
  5. María Dolores Martín4,
  6. Miguel A Sánchez-González5
  1. 1Department of Biomedical Sciences, European University of Madrid, Villaviciosa de Odon, Madrid, Spain
  2. 2Department of Respiratory Care, St. Joseph Hospital, Eureka, California, USA
  3. 3Kennedy Institute of Ethics, Georgetown University, Washington DC, USA
  4. 4Preventive Medicine Unit, Rey Juan Carlos Hospital, Mostoles, Madrid, Spain
  5. 5School of Medicine, Complutense University, Madrid, Madrid, Spain
  1. Correspondence to Benjamin Herreros, Department of Biomedical Sciences, European University of Madrid, Villaviciosa de Odon, 28.670, Madrid, Spain; benjaminherreros{at}


Introduction Currently, The nature and scope of Clinical Ethics Protocols (CEPs) in Madrid (Spain) are not well understood.

Objectives The main objective is to describe the features of ‘guideline/recommendation’ type CEPs that have been or are being developed by existing Clinical Ethics Committees (CECs) in Madrid. Secondary objectives include characterisation of those CECs that have been the most prolific in reference to CEP creation and implementation and identification of any trends in future CEP development.

Methods We collected CEPs produced and in process by CECs accredited in the public hospitals in Madrid, Spain, from 1996 to 2008.

Results CECs developed 30 CEPs, with 10 more in process. The most common topic is refusal of treatment (seven CEPs developed; two in process). If CEPs addressing terminal illness, Do-Not-Resuscitate orders and advance directives are placed into a separate ‘ethical problems at the end of life’ category, this CEP subject emerges as the most common (eight developed; four in process). There is a relationship between the age of the CEC and the development of CEPs (the oldest CECs have developed more CEPs). CECs now seem to be more likely to engage in CEP development.

Conclusions The CECs in Madrid, Spain, have developed a significant number of CEPs (30 in total and 10 in process) and there is a trend towards continued development. The most frequent topics are ethical problems at the end of life and refusal of treatment by the patient.

  • Clinical Ethics
  • Ethics Committees/Consultation
  • Regulation
  • Managed Care

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