scholarly journals Clinical ethics support services during the COVID-19 pandemic in the UK: a cross-sectional survey

2021 ◽  
pp. medethics-2021-107818
Author(s):  
Mariana Dittborn ◽  
Emma Cave ◽  
David Archard
Keyword(s):  
Support Services ◽  
Clinical Ethics ◽  
Research Team ◽  
Moral Distress ◽  
Clinical Staff ◽  
Cross Sectional ◽  
Clinical Ethics Support ◽  
Ethics Support ◽  
Advisory Boards ◽  
The Uk

BackgroundThe 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.PurposeTo describe the availability, characteristics and role of clinical ethics support services (CESSs) in the UK during the COVID-19 pandemic.MethodA 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.ResultsBetween 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.ConclusionsThe 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.

Developing a Model of Healthcare Ethics Support in Croatia

2010 ◽  
Vol 19 (3) ◽  
pp. 395-401 ◽  
Author(s):  
ANA BOROVEČKI ◽  
KSENIJA MAKAR-AUS̆PERGER ◽  
IGOR FRANCETIĆ ◽  
SANJA BABIĆ-BOSNAC ◽  
BERT GORDIJN ◽  
...  
Keyword(s):  
Support Services ◽  
Clinical Ethics ◽  
Structural Changes ◽  
Treatment Options ◽  
University Hospital ◽  
Medical Team ◽  
Healthcare Ethics ◽  
Clinical Ethics Support ◽  
Ethics Support ◽  
System A

Croatia is a transitional society in that it is a country emerging from a socialist command economy toward a market-based economy with ensuing structural changes of a social and political nature—some extending into the healthcare system. A legacy from our past is that, until now, Croatian healthcare institutions have had no real experience with clinical ethics support services. When clinical cases arise presenting complex ethical dilemmas in treatment options, the challenges presented to the medical team are substantial. The case described below recently occurred on a ward in a university hospital in Croatia. An unexpected request from the patient’s parents created a number of issues that needed to be addressed by the medical team, which was made more difficult by the lack of clinical ethics support services. Such cases press the question currently being debated as to what type of ethics support services would be suitable for Croatia and why.

The UK Genethics Club: clinical ethics support for genetic services

2006 ◽  
Vol 1 (4) ◽  
pp. 219-223 ◽  
Author(s):  
Anneke Lucassen ◽  
Michael Parker
Keyword(s):  
Clinical Ethics ◽  
Genetic Services ◽  
Clinical Ethics Support ◽  
Ethics Support ◽  
The Uk

Outcomes of clinical ethics support near the end of life: A systematic review

2019 ◽  
Vol 27 (3) ◽  
pp. 838-854 ◽  
Author(s):  
Joschka Haltaufderheide ◽  
Stephan Nadolny ◽  
Marjolein Gysels ◽  
Claudia Bausewein ◽  
Jochen Vollmann ◽  
...  
Keyword(s):  
Systematic Review ◽  
End Of Life ◽  
Support Services ◽  
Clinical Ethics ◽  
Methodological Quality ◽  
Qualitative Studies ◽  
Mixed Method Research ◽  
Clinical Ethics Support ◽  
Negative Results ◽  
Ethics Support

Background: Clinical ethics support services have been advocated in recent decades. In clinical practice, clinical ethics support services are often requested for difficult decisions near the end of life. However, their contribution to improving healthcare has been questioned and demands for evaluation have been put forward. Research indicates that there are considerable challenges associated with defining adequate outcomes for clinical ethics support services. In this systematic review, we report findings of qualitative studies and surveys, which have been conducted to evaluate clinical ethics support services near the end of life. Methods: Electronic databases and other sources were queried from 1970 to May 2018. Two authors screened studies independently. Methodological quality of studies was assessed. For each arm of the review, an individual synthesis was performed. Prospero ID: CRD42016036241. Ethical Considerations: Ethical approval is not needed as it is a systematic review of published literature. Results: In all, 2088 hits on surveys and 2786 on qualitative studies were found. After screening, nine surveys and four qualitative studies were included. Survey studies report overall positive findings using a very wide and heterogeneous range of outcomes. Negative results were reported only occasionally. However, methodological quality and conceptual justification of used outcomes was often weak and limits generalizability of results. Conclusion: Evidence points to positive outcomes of clinical ethics support services. However, methodological quality needs to be improved. Further qualitative or mixed-method research on evaluating clinical ethics support services may contribute to the development of evaluating outcomes of clinical ethics support services by means of broaden the range of appropriate (process-oriented) outcomes of (different types of) clinical ethics support services.

Methodological Reflections on the Contribution of Qualitative Research to the Evaluation of Clinical Ethics Support Services

Bioethics ◽  
2017 ◽  
Vol 31 (4) ◽  
pp. 237-245 ◽  
Author(s):  
Sebastian Wäscher ◽  
Sabine Salloch ◽  
Peter Ritter ◽  
Jochen Vollmann ◽  
Jan Schildmann
Keyword(s):  
Qualitative Research ◽  
Support Services ◽  
Clinical Ethics ◽  
Clinical Ethics Support ◽  
Ethics Support

Evaluating clinical ethics support in mental healthcare

2014 ◽  
Vol 22 (4) ◽  
pp. 452-466 ◽  
Author(s):  
Marit Helene Hem ◽  
Reidar Pedersen ◽  
Reidun Norvoll ◽  
Bert Molewijk
Keyword(s):  
Support Services ◽  
Clinical Ethics ◽  
Good Practice ◽  
Mental Healthcare ◽  
Grey Zone ◽  
Ethical Challenges ◽  
Clinical Ethics Support ◽  
Quantitative Research Methods ◽  
Ethics Support ◽  
Ethics Rounds

A systematic literature review on evaluation of clinical ethics support services in mental healthcare is presented and discussed. The focus was on (a) forms of clinical ethics support services, (b) evaluation of clinical ethics support services, (c) contexts and participants and (d) results. Five studies were included. The ethics support activities described were moral case deliberations and ethics rounds. Different qualitative and quantitative research methods were utilized. The results show that (a) participants felt that they gained an increased insight into moral issues through systematic reflection; (b) there was improved cooperation among multidisciplinary team members; (c) it was uncertain whether clinical ethics support services led to better patient care; (d) the issue of patient and client participation is complex; and (e) the implementation process is challenging. Clinical ethics support services have mainly been studied through the experiences of the participating facilitators and healthcare professionals. Hence, there is limited knowledge of whether and how various types of clinical ethics support services influence the quality of care and how patients and relatives may evaluate clinical ethics support services. Based on the six excluded ‘grey zone articles’, in which there was an implicit focus on ethics reflection, other ways of working with ethical reflection in practice are discussed. Implementing and evaluating clinical ethics support services as approaches to clinical ethics support that are more integrated into the development of good practice are in focus. In order to meet some of the shortcomings of the field of clinical ethics support services, a research project that aims to strengthen ethics support in the mental health services, including patients’ and caregivers’ views on ethical challenges, is presented.

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