Galván Román José María, Fernández Bueno Julia, Sánchez González Miguel Ángel, Real de Asúa Cruzat Diego
Servicio de Medicina Interna. Comité de Ética de la Asistencia Sanitaria. Hospital Universitario de La Princesa. c/ Diego de León 62. CP 28006. Madrid. España. Teléfono: +34 915 202 222. Fax: + 34 915 202 209.
Unidad de Cuidados Paliativos. Comité de Ética de la Asistencia Sanitaria. Hospital Universitario de La Princesa.
Cuad Bioet. 2021 Jan-Apr;32(104):75-87. doi: 10.30444/CB.89.
To date, healthcare ethics committees (HEC) have been the only ethics consultation model in the hospital setting in Spain, though their usefulness for ethical conflict resolution in daily practice has been questioned. Individual clinical ethics consultation (CEC) is a complementary ethics consultation model, which has proved efficacious in real-time ethical problem-solving. Although CEC is widely used in North America, its implementation in Europe is still marginal. In this document we present the general characteristics of CEC services, comparing their potential advantages and risks to those of HECs. We will then share relevant European experiences in CEC, as well as review the few CEC initiatives in Spain. Finally, we will share our recent CEC implementation strategy in a national, medium-sized, teaching hospital. We will summarise the minimum requirements that such a CEC service must meet in order to carry out its consulting activity: organisational flexibility, well-trained professionals, with sufficient clinical experience, economical support, and organisational dependency on HECs.
迄今为止,医疗伦理委员会(HEC)一直是西班牙医院环境中唯一的伦理咨询模式,尽管其在日常实践中解决伦理冲突的有效性受到了质疑。个体临床伦理咨询(CEC)是一种补充性的伦理咨询模式,已被证明在实时解决伦理问题方面是有效的。虽然CEC在北美被广泛使用,但其在欧洲的实施仍然有限。在本文中,我们介绍了CEC服务的一般特征,将其潜在优势和风险与HEC的进行比较。然后,我们将分享欧洲在CEC方面的相关经验,并回顾西班牙的少数CEC举措。最后,我们将分享我们最近在一家全国性的中型教学医院实施CEC的策略。我们将总结这种CEC服务为开展其咨询活动必须满足的最低要求:组织灵活性、训练有素的专业人员、足够的临床经验、经济支持以及对HEC的组织依赖性。