Blot François, Vigouret-Viant Laurence, Valteau-Couanet Dominique, Verotte Nelly, Ponzio Anne, Massard Christophe, Marsico Giovanna, Lacaze-Guillet Marilène, Hubert Nicole, Dumont Sarah, de Jesus Anne, Nicotra Laetitia, Chardonnet Florent, Billaud Véronique
Université Paris-Saclay, Gustave Roussy - Cancer Campus, service de médecine intensive réanimation, 114, rue Édouard-Vaillant, 94800 Villejuif, France.
Gustave Roussy - Cancer Campus, département interdisciplinaire de soins de support, 114, rue Édouard-Vaillant, 94800 Villejuif, France.
Bull Cancer. 2019 Dec;106(12):1144-1151. doi: 10.1016/j.bulcan.2019.06.008. Epub 2019 Oct 5.
The Ethics committee of Gustave Roussy cancer center is devoted to both reflection and action. The group has 40 members, professionals, patients and outside experts. These meet in plenary meetings or in specific working sessions and intervene at the request of any professional faced with ethical questions in the care. This Ethics Committee has voluntarily a double vocation: on one hand, a reflective group on major issues of ethics in health and its involvement in hospital life; on the other hand, a working group embedded in the daily lives of the care. The themes addressed at the meetings (plenary sessions, annual meetings) include shared-decision making, advance directives, refusal of care, religious aspects, or biomedical research… Daily activity centered on the care revolves around several times a week meetings, in various services, "Supportive Collegial Meetings" such as proposed in the 3rd French Cancer Plan; these include nursing staff members, oncologists, intensive and palliative care specialists, psychologist, around difficult medical and/or ethical situations. In case of situation requiring an urgent discussion, a referral to the Ethics Committee brings together within 24hours four to five members of the Committee and the care team. Moreover, the Ethics Committee helped develop Aid to Decision making Form upon care gradation for hospitalized cancer patients. Through these interventions on a daily basis, assistance of professionals, reflexive vocation or even delivery of training, the Ethics Committee contributes to an acculturation around anticipation and collegiality in the care. Its double polarity aims to reconcile "philosophical time' for the ethics process, and the connection with the routine issues raised by patients, their families and caregivers.
古斯塔夫·鲁西癌症中心伦理委员会致力于思考与行动。该委员会有40名成员，包括专业人员、患者及外部专家。他们会召开全体会议或特定工作会议，并应任何在医疗护理中面临伦理问题的专业人员的请求进行干预。这个伦理委员会自愿承担双重职责：一方面，作为一个思考健康领域重大伦理问题及其在医院生活中参与情况的团体；另一方面，作为一个融入日常护理工作的工作组。会议（全体会议、年会）讨论的主题包括共同决策、预立医疗指示、拒绝治疗、宗教方面或生物医学研究等。以护理为中心的日常活动围绕每周数次在不同科室召开的“支持性合议会议”展开，就像法国第三个癌症防治计划中提议的那样；这些会议包括护理人员、肿瘤学家、重症和姑息治疗专家、心理学家，讨论棘手的医疗和/或伦理情况。如果遇到需要紧急讨论的情况，提交给伦理委员会后，委员会的四到五名成员和护理团队会在24小时内齐聚。此外，伦理委员会还协助制定了针对住院癌症患者护理分级的决策辅助表格。通过这些日常干预、对专业人员的协助、反思职责甚至培训的开展，伦理委员会有助于在护理中培养围绕预期和合议的文化。其双重性质旨在协调伦理过程的“哲学时间”与患者、其家属和护理人员提出的日常问题之间的联系。
