Article Text

Download PDFPDF
Measuring the impact of clinical ethics support services: further points for consideration
  1. Virginia Sanchini1,
  2. Chiara Crico2,
  3. Paolo G Casali1,
  4. Gabriella Pravettoni1
  1. 1 Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy
  2. 2 Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy
  1. Correspondence to Virginia Sanchini, Department of Oncology and Hemato-Oncology, University of Milan, Milano 20122, Italy; virginia.sanchini{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

In their contribution, Kok et al raise a relevant, though often underestimated, issue: clinical ethics support services (CESS) are often assumed to lead to an improvement of quality of care at the organisational level, but evidence in support of this claim is weak, if not completely lacking.1 Therefore, the authors propose a complex theoretical model connecting a specific kind of CESS, moral case deliberation (MCD), with mechanisms for quality of care improvement at the individual and the organisational level.

The proposal is original, and the topic discussed of great interest not only to practitioners and researchers dealing with CESS, but also to health policy-makers and managers of healthcare system, for all of whom it is indeed crucial to understand whether and how ethics support can positively impact quality of care. However, despite its undoubtful merits, we feel that some claims and model’s underlying assumptions might require in-depth scrutiny and more solid justification.

i. First, the authors discuss two different approaches to understanding quality of care: the first approach, which they define as reductionist, interprets quality as an outcome-oriented, quantitative, and therefore, measurable function. The second approach defines quality …

View Full Text


  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

Linked Articles

Other content recommended for you