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Importance of systematic deliberation and stakeholder presence: a national study of clinical ethics committees
  1. Morten Magelssen1,
  2. Reidar Pedersen1,
  3. Ingrid Miljeteig2,3,
  4. Håvard Ervik4,
  5. Reidun Førde1
  1. 1Centre for Medical Ethics, University of Oslo, Oslo, Norway
  2. 2Department of Research and Development, Haukeland University Hospital, Bergen, Norway
  3. 3Bergen Center for Ethics and Priority Setting, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
  4. 4Clinical Ethics Committee, Møre og Romsdal Hospital Trust, Ålesund, Norway
  1. Correspondence to Dr Morten Magelssen, Centre for Medical Ethics, University of Oslo, N-0318 Oslo, Norway; morten.magelssen{at}medisin.uio.no

Abstract

Background Case consultation performed by clinical ethics committees (CECs) is a complex activity which should be evaluated. Several evaluation studies have reported stakeholder satisfaction in single institutions. The present study was conducted nationwide and compares clinicians’ evaluations on a range of aspects with the CEC’s own evaluation.

Methods Prospective questionnaire study involving case consultations at 19 Norwegian CECs for 1 year, where consultations were evaluated by CECs and clinicians who had participated.

Results Evaluations of 64 case consultations were received. Cases were complex with multiple ethical problems intertwined. Clinicians rated the average CEC consult highly, being both satisfied with the process and perceiving it to be useful across a number of aspects. CEC evaluations corresponded well with those of clinicians in a large majority of cases. Having next of kin/patients present was experienced as predominantly positive, though practised by only half of the CECs. The educational function of the consult was evaluated more positively when the CEC used a systematic deliberation method.

Conclusions CEC case consultation was found to be a useful service. The study is also a favourable evaluation of the Norwegian CEC system, implying that it is feasible to implement well-functioning CECs on a large scale. There are good reasons to involve the stakeholders in the consultations as a main rule.

  • clinical ethics
  • ethics committees/consultation
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Footnotes

  • Contributors All authors contributed to design and analysis, and to revision of the text. MM had main responsibility for data collection and analysis, and wrote the first draft. All authors approved of the final version.

  • Funding MM, RP and RF’s work was funded by a grant from the Norwegian Ministry of Health and Care Services.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the Data Protection Official at the Norwegian Centre for Research Data (ref. 48902). In order to preserve the anonymity of patients and other stakeholders, the questionnaires contained no questions that could identify individuals.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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