The establishment of a hospital clinical ethics committee.

In the Republic of Ireland the establishment of Clinical Ethics Committees (CECs) are relatively new. The need for such committees has occurred due to the fact that the consideration of ethical issues in healthcare has become an important and frequent part of discussions by individuals and institutions. A number of factors have contributed to this growth of ethical considerations. The Bon Secours Health System (BSHS) decided to establish a CEC and appointed a co-ordinating team to draw up terms of reference for such a committee. During this process the co-ordinating team drew on the experience of other countries and of its own staff. Potential criticisms of how such a committee would function were examined. A representative membership of the CEC was also arrived at. The following functions were identified for a CEC: the need to provide a mechanism for the identification, discussion and resolution of medical ethical issues; the need to identify medical ethical issues which may create challenges to the health system and to monitor the responses of the health system to these areas, and the provision of education. Policy development was seen as a primary function of the CEC. Ethical case review also emerged as one area of potential involvement by the CEC. During the staff consultation a large number of ethical issues emerged which the staff requested the CEC to address. A methodology necessary for coping with the differences within the BSHS was developed by the CEC. It is evident that CECs are here to stay and how they develop and function will have an impact on the quality of healthcare.