Clinical ethics committees’ advice when deciding for critically ill infants: An answer to a problem or a problem to answer?

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Clinical ethics committees (of which there are at least 82 in the UK) can advise on ethical dilemmas arising in clinical practice, including those occurring in paediatric intensive care units (PICU). Such committees appear capable of providing ethical scrutiny and, as such, can supplement more legalistic understandings of a child’s “best interests”. In this paper, we initially discuss some of the deficiencies of the legal gaze and of recourse to the courts to resolve disputes arising in PICU. We then ask if (and, indeed, what) clinical ethics committees could contribute to the resolution of such disputes. To answer this question, we draw upon the results of a recent Wellcome Trust-funded empirical ethics study, which (qualitatively) explored the views of children’s intensive care doctors, nurses, clinical ethics committee members and parents in three hospitals.

Whilst almost all participants wished to avoid the courts, participants revealed hurdles to clinical ethics committees’ involvement in resolving conflicts on the clinic. Many clinical ethics committee members were concerned that they received few referrals, but they also expressed caution about opening the referral process to non-clinicians. Parents were unaware of the existence of clinical ethics committees, while nurses reported little involvement therewith, even when they had been aware of referrals. There were widespread concerns about committee expertise and membership. Among doctors, perceptions of clinical ethics committees’ effectiveness varied strikingly depending on location.

We consider what these findings tell us about the ways in which clinical ethics support needs to develop in the UK. While the findings suggest some of the issues on which committees should focus – such as the referral process, composition, and the vexed question of expertise – they also indicate some important questions that need to be resolved about the role and function of clinical ethics committees.
Original languageEnglish
Publication statusPublished - 18 Jun 2015
EventInstitute of Medical Ethics - University of Newcastle, Newcastle, United Kingdom
Duration: 18 Jun 201518 Jun 2015


ConferenceInstitute of Medical Ethics
CountryUnited Kingdom


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