Clinical Ethics Committees and Ethics Consultation in Psychiatry

Abstract

While research ethics committees in the field of medicine are quite well known and established, clinical ethics committees and clinical ethics consultation are fairly new to many European countries. Research ethics councils have been working with legal authorisation since the 1970s at medical schools and state medical associations. Their members, (researching) physicians, pharmacologists and pharmacists, legal experts, biometricians, etc. vote their approval or disapproval on ethical issues regarding clinical trials on human beings in medical research. These bodies working in the field of research ethics should be distinguished from clinical ethics committees that advise on ethical issues in the day-to-day clinical care of patients. The development of clinical ethics consultation in many European countries in the last 10 years has been characterised by an increase and growing differentiation and professionalisation of different forms of clinical ethics consultation. The appointment of clinical ethicists who work on a regular basis as part of the hospital staff, the provision of structured advanced training courses, curricula and recommendations have all contributed to a professionalisation of the field. Although much progress has been made over the last years in making the field of clinical ethics consultation more professional, one has to point out that in most European countries only a very limited number of professionally trained clinical ethicists exist. Therefore most of the everyday work of clinical ethics consultation is provided by doctors, nurses, chaplains and other health professionals beside their main duties in the hospitals. Although a growing number of these clinical ethics consultation members have received some training in clinical ethics and moderation skills beside their main professional obligations, we have not reached a level of professionalism in clinical ethics consultation which we expect in all other fields of clinical medicine. To improve this situation, more priority and resources within the health care sector must be invested into the field of clinical ethics. To a great extent, this development has also taken place in mental hospitals. But in contrast to somatic medicine, there are differences due to the disease pictures, professional requirements and institutional patient care structures, which were discussed in this article. (PsycINFO Database Record (c) 2016 APA, all rights reserved)