Background The COVID-19 pandemic highlighted the need for clinical ethics support provision to ensure as far as possible fair decision making and to address healthcare workers’ moral distress.
Purpose To describe the availability, characteristics and role of clinical ethics support services (CESSs) in the UK during the COVID-19 pandemic.
Method A descriptive cross-sectional online survey was developed by the research team. The survey included questions on CESSs characteristics (model, types of support, guidance development, membership, parent and patient involvement) and changes in response to the pandemic. Invitations to participate were widely circulated via National Health Service institutional emails and relevant clinical ethics groups known to the research team.
Results Between October 2020 and June 2021, a total of 53 responses were received. In response to the pandemic, new CESSs were established, and existing provision changed. Most took the form of clinical ethics committees, groups and advisory boards, which varied in size and membership and the body of clinicians and patient populations they served. Some services provided moral distress support and educational provision for clinical staff. During the pandemic, services became more responsive to clinicians’ requests for ethics support and advice. More than half of respondents developed local guidance and around three quarters formed links with regional or other local services. Patient and/or family members’ involvement in ethics discussions is infrequent.
Conclusions The pandemic has resulted in an expansion in the number of CESSs. Though some may disband as the pandemic eases, the reliance on CESSs during the pandemic demonstrates the need for additional research to better understand the effectiveness of their various forms, connections, guidance, services and modes of working and for better support to enhance consistency, transparency, communication with patients and availability to clinical staff.
- ethics committees
- ethics- medical
Data availability statement
Data are available on reasonable request. Data are available upon reasonable request.
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Contributors MD designed the survey in conjunction with DA and EC. MD drafted the results, and DA and EC drafted the discussion. All authors finalised and approved the submission. MD is responsible for the overall content as guarantor.
Funding The authors acknowledge the support of the British Academy, grant number COV19\200446 for their project ‘Ethical advice and ethics committees in the pandemic’ June 2020-July 2021.
Competing interests DA and MD are members of the GOSH Paediatric Bioethics Centre.
Provenance and peer review Not commissioned; externally peer reviewed.
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