Faculty of Health and Medicine, Lancaster Medical School, Lancaster University, Lancaster, UK.
Royal Lancaster Infirmary, University Hospitals of Morecambe Bay Hospital Foundation Trust, Lancaster, UK.
HEC Forum. 2021 Dec;33(4):371-391. doi: 10.1007/s10730-020-09416-6.
This paper provides a series of reflections on making the case to senior leaders for the introduction of clinical ethics support services within a UK hospital Trust at a time when clinical ethics committees are dwindling in the UK. The paper provides key considerations for those building a (business) case for clinical ethics support within hospitals by drawing upon published academic literature, and key reports from governmental and professional bodies. We also include extracts from documents relating to, and annual reports of, existing clinical ethics support within UK hospitals, as well as extracts from our own proposal submitted to the Trust Board. We aim for this paper to support other ethicists and/or health care staff contemplating introducing clinical ethics support into hospitals, to facilitate the process of making the case for clinical ethics support, and to contribute to the key debates in the literature around clinical ethics support. We conclude that there is a real need for investment in clinical ethics in the UK in order to build the evidence base required to support the wider introduction of clinical ethics support into UK hospitals. Furthermore, our perceptions of the purpose of, and perceived needs met through, clinical ethics support needs to shift to one of hospitals investing in their staff. Finally, we raise concerns over the optional nature of clinical ethics support available to practitioners within UK hospitals.
本文就英国某医院信托机构在临床伦理委员会日渐式微之际引入临床伦理支持服务一事向高层领导进行说明,提出了一系列反思。本文通过引用已发表的学术文献和政府及专业机构的重要报告,为那些在医院内部建立(商业)临床伦理支持案例的人提供了关键的考虑因素。我们还收录了与英国医院现有临床伦理支持相关的文件和年度报告的摘录,以及我们提交给信托委员会的提案摘录。我们希望本文能够为其他考虑将临床伦理支持引入医院的伦理学家和/或医疗保健人员提供支持,以促进临床伦理支持的说明过程,并为文献中围绕临床伦理支持的关键辩论做出贡献。我们得出的结论是,英国非常有必要在临床伦理方面进行投资,以建立支持临床伦理支持更广泛引入英国医院所需的证据基础。此外,我们对临床伦理支持的目的和通过临床伦理支持满足的需求的看法需要转变为医院对员工进行投资的角度。最后,我们对英国医院内部为从业者提供的可选性临床伦理支持表示担忧。