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Clinical ethics committees in Norway: what do they do, and does it make a difference?

https://arctichealth.org/en/permalink/ahliterature133693
Source
Camb Q Healthc Ethics. 2011 Jul;20(3):389-95
Publication Type
Article
Date
Jul-2011
Author
Reidun Førde
Reidar Pedersen
Author Affiliation
Center for Medical Ethics, University of Oslo, Norway.
Source
Camb Q Healthc Ethics. 2011 Jul;20(3):389-95
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Ethics Committees, Clinical - organization & administration - standards - trends
Ethics Consultation - organization & administration - standards - trends
Hospitals - ethics
Humans
Norway
Patient Advocacy
Quality Assurance, Health Care
Questionnaires
Abstract
The first clinical ethics committees (CEC) in Norway were established in 1996. This started as an initiative from hospital clinicians, the Norwegian Medical Association, and health authorities and politicians. Norwegian hospitals are, by and large, publicly funded through taxation, and all inpatient treatment is free of charge. Today, all the 23 hospital trusts (providing specialized and hospital-based healthcare services to the Norwegian population of 4.9 million people) have established at least one committee. Center for Medical Ethics (SME), University of Oslo, receives an annual amount of US$335,000 from the Ministry of Health and Care Services to coordinate the committees and to facilitate competency building for committee members.
PubMed ID
21676326 View in PubMed
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Discussing End-of-Life Decisions in a Clinical Ethics Committee: An Interview Study of Norwegian Doctors' Experience.

https://arctichealth.org/en/permalink/ahliterature282851
Source
HEC Forum. 2016 Sep;28(3):261-72
Publication Type
Article
Date
Sep-2016
Author
Marianne K Bahus
Reidun Førde
Source
HEC Forum. 2016 Sep;28(3):261-72
Date
Sep-2016
Language
English
Publication Type
Article
Keywords
Case-Control Studies
Decision Making - ethics
Ethics Committees, Clinical - organization & administration
Female
Humans
Male
Negotiating - methods
Norway
Physicians - ethics - psychology
Qualitative Research
Terminal Care - ethics
Abstract
With disagreement, doubts, or ambiguous grounds in end-of-life decisions, doctors are advised to involve a clinical ethics committee (CEC). However, little has been published on doctors' experiences with discussing an end-of-life decision in a CEC. As part of the quality assurance of this work, we wanted to find out if clinicians have benefited from discussing end-of-life decisions in CECs and why. We will disseminate some Norwegian doctors' experiences when discussing end-of-life decisions in CECs, based on semi-structured interviews with fifteen Norwegian physicians who had brought an end-of-life decision case to a CEC. Almost half of the cases involved conflicts with the patients' relatives. In a majority of the cases, there was uncertainty about what would be the ethically preferable solution. Reasons for referring the case to the CEC were to get broader illumination of the case, to get perspective from people outside the team, to get advice, or to get moral backing on a decision already made. A great majority of the clinicians reported an overall positive experience with the CECs' discussions. In cases where there was conflict, the clinicians reported less satisfaction with the CECs' discussions. The study shows that most doctors who have used a CEC in an end-of-life decision find it useful to have ethical and/or legal aspects illuminated, and to have the dilemma scrutinized from a new perspective. A systematic discussion seems to be significant to the clinicians.
PubMed ID
26922945 View in PubMed
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Doing the right thing! A model for building a successful hospital-based ethics committee in Nunavut.

https://arctichealth.org/en/permalink/ahliterature284322
Source
Pages 883-887 in N. Murphy and A. Parkinson, eds. Circumpolar Health 2012: Circumpolar Health Comes Full Circle. Proceedings of the 15th International Congress on Circumpolar Health, Fairbanks, Alaska, USA, August 5-10, 2012. International Journal of Circumpolar Health 2013;72 (Suppl 1):883-887
Publication Type
Article
Date
2013
  1 document  
Author
Cole M
Healey G.
Author Affiliation
Qikiqtani General Hospital, Iqaluit, Nunavut, Canada
Source
Pages 883-887 in N. Murphy and A. Parkinson, eds. Circumpolar Health 2012: Circumpolar Health Comes Full Circle. Proceedings of the 15th International Congress on Circumpolar Health, Fairbanks, Alaska, USA, August 5-10, 2012. International Journal of Circumpolar Health 2013;72 (Suppl 1):883-887
Date
2013
Language
English
Publication Type
Article
Digital File Format
Text - PDF
Physical Holding
University of Alaska Anchorage
Keywords
Culture
Ethics Committees, Clinical/organization & administration
Hospitals/ethics
Humans
Inuits/ethnology
Models, organizational
Nunavut
Documents
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Evolution of hospital clinical ethics committees in Canada.

https://arctichealth.org/en/permalink/ahliterature145000
Source
J Med Ethics. 2010 Mar;36(3):132-7
Publication Type
Article
Date
Mar-2010
Author
Alice Gaudine
Linda Thorne
Sandra M LeFort
Marianne Lamb
Author Affiliation
School of Nursing, Memorial University of Newfoundland, St John's NL A1B 3V6, Canada.
Source
J Med Ethics. 2010 Mar;36(3):132-7
Date
Mar-2010
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Canada
Committee Membership
Ethics Committees, Clinical - organization & administration - trends
Hospital Administration - trends
Hospital Bed Capacity
Humans
Questionnaires
Abstract
To investigate the current status of hospital clinical ethics committees (CEC) and how they have evolved in Canada over the past 20 years, this paper presents an overview of the findings from a 2008 survey and compares these findings with two previous Canadian surveys conducted in 1989 and 1984. All Canadian hospitals over 100 beds, of which at least some were acute care, were surveyed to determine the structure of CEC, how they function, the perceived achievements of these committees and opinions about areas with which CEC should be involved. The percentage of hospitals with CEC in our sample was found to be 85% compared with 58% and 18% in 1989 and 1984, respectively. The wide variation in the size of committees and the composition of their membership has continued. Meetings of CEC have become more regularised and formalised over time. CEC continue to be predominately advisory in their nature, and by 2008 there was a shift in the priority of the activities of CEC to meeting ethics education needs and providing counselling and support with less emphasis on advising about policy and procedures. More research is needed on how best to define what the scope of activities of CEC should be in order to meet the needs of hospitals in Canada and elsewhere. More research also is needed on the actual outcomes to patients, families, health professionals and organisations from the work of these committees in order to support the considerable time committee members devote to this endeavour.
PubMed ID
20211990 View in PubMed
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HEC member perspectives on the case analysis process: a qualitative multi-site study.

https://arctichealth.org/en/permalink/ahliterature161197
Source
HEC Forum. 2007 Sep;19(3):185-206
Publication Type
Article
Date
Sep-2007
Author
Eric Racine
Author Affiliation
Neuroethics Research Unit, Institut de recherches cliniques de Montréal, 110 avenue des Pins Ouest, Montréal, QC H2W lR7, Canada. eric.racine@ircm.qc.ca
Source
HEC Forum. 2007 Sep;19(3):185-206
Date
Sep-2007
Language
English
Publication Type
Article
Keywords
Ethicists - psychology
Ethics Committees, Clinical - organization & administration
Hospitals
Humans
Interviews as Topic
Qualitative Research
Quebec
PubMed ID
17882510 View in PubMed
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What is happening during case deliberations in clinical ethics committees? A pilot study.

https://arctichealth.org/en/permalink/ahliterature152343
Source
J Med Ethics. 2009 Mar;35(3):147-52
Publication Type
Article
Date
Mar-2009
Author
R. Pedersen
V. Akre
R. Førde
Author Affiliation
Department of General Practice and Community Medicine, Section for Medical Ethics, University of Oslo, Oslo, Norway. reidar.pedersen@medisin.uio.no
Source
J Med Ethics. 2009 Mar;35(3):147-52
Date
Mar-2009
Language
English
Publication Type
Article
Keywords
Communication
Ethics Committees, Clinical - organization & administration - standards
Ethics Consultation - organization & administration - standards
Humans
Norway
Pilot Projects
Program Evaluation - standards
Abstract
Clinical ethics consultation services have been established in many countries during recent decades. An important task is to discuss concrete clinical cases. However, empirical research observing what is happening during such deliberations is scarce.
To explore clinical ethics committees' deliberations and to identify areas for improvement.
A pilot study including observations of committees deliberating a paper case, semistructured group interviews, and qualitative analysis of the data.
Nine hospital ethics committees in Norway.
Key elements of the deliberations included identifying the ethical problems; exploring moral values and principles; clarifying key concepts and relevant legal regulation; exploring medical facts, the patient's situation, the therapists' perspective, analogous clinical situations, professional uncertainties, the patient's and relatives' perspective, and clinical communication; identifying the involved parties and how to involve them; identifying possible courses of action, and possible conclusion and follow-up. The various elements were closely interwoven. The content and conclusions varied and seemed to be contingent on the committee members' interpretations, experience and knowledge. Important aspects of a clinical ethics deliberation were sometimes neglected. When the committees used a deliberation procedure and a blackboard, the deliberations tended to become more systematic and transparent. Many of the committees were insecure about how to include the involved parties and how to document the deliberations.
Clinical ethics committees may provide an important arena for multidisciplinary discussions of complex clinical ethics challenges. However, this seems to require adequate composition, adoption of transparent deliberation procedures, and targeted training.
PubMed ID
19251963 View in PubMed
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9 records – page 1 of 1.