Challenges of hospital ethics committees: a phenomenological study
Medical ethics committees play an important role in examining and resolving ethical problems in hospitals by developing ethical guidelines and making ethical decisions. This study aimed at investigating the challenges that these committees typically face.This qualitative phenomenological study was conducted in 2020. Data was collected through semi-structured interviews with purposive sampling and participation of 19 ethics committees’ members in Tehran hospitals. Then, data were analyzed by the content analysis method using MAXQDA-10 software. Challenges of hospital ethics committees were classified into three main themes including external factors, intra-organizational factors, and ethics committee structure, in addition to six sub-themes including inadequate supervision, lack of instructions, organizational culture, human resources, nature of the committee, and ineffectiveness of committees’ decisions.Since many challenges are faced by ethics committees, plans should be developed and implemented to fulfill the following purposes: (i) strengthen the position of these committees in hospitals, (ii) continuous supervision over the formation and holding of the committees, (iii) their operation process, (iv) their decision-making process, and (v) process of sharing committees’ decisions with all hospital stakeholders and staff.
Larcher V, Slowther AM, Watson AR. Core competencies for clinical ethics committees. Clin Med (Lond). 2010; 10(1): 30-3.
Joolae S, Cheraghi MA, Hajibabaee F. Are hospital ethics committees necessary? Medical Ethics and History. 2015; 8(4): 12-20.
Bagheri A. Iranian medical ethics priorities: the results of a national study. Medical Ethics and History of Medicine. 2011; 4(5): 39-48.
Aulisio MP. Why did hospital ethics committees emerge in the US? AMA J Ethics. 2016; 18(5): 546-53.
Petrini C, Ricciardi W. Clinical ethics and the role of clinical ethics committees: proposals for a revival. Commentary. Ann Ist Super Sanita. 2017; 53(3): 183-4.
Slowther A, Johnston C, Goodall J, Hope T. A practical guide for clinical ethics support. [cited Dec 2021]; Available from: http://www.ukcen.net/uploads/docs/education_resources/prac_guide.pdf
Anonymous. [Rahnamaye jame estandardhaye etebarbakhshi melli bimarestanhaye Iran]. [cited Dec 2021]; Available from: http://treatment.sbmu.ac.ir/uploads/etebarbakhshi_standard_book_98.pdf
Hajibabaee F, Joolaee S, Cheraghi MA, Salari P, Rodney P. Hospital/clinical ethics committees' notion: an overview. J Med Ethics Hist Med. 2016; 9: 17.
Doran E, Fleming J, Kerridge I, Stewart C. Clinical ethics support: literature review. [cited Dec 2021]; Available from: https://www.health.nsw.gov.au/clinicalethics/Publications/clinical-ethics-literature-review.pdf
McCarrick PM. Ethics committees in hospitals. Kennedy Inst Ethics J. 1992; 2(3): 285-306.
McGee G, Spanogle JP, Caplan AL, Penny D, Asch DA. Successes and failures of hospital ethics committees: a national survey of ethics committee chairs. Cam Q Healthc Ethics. 2002; 11(1): 87-93.
Mercurio M. The role of a pediatric ethics committee in the newborn intensive care unit. J Perinatol. 2011; 31(1): 1-9.
Bruun H, Lystbaek S, Stenager E, Huniche L, Pedersen R. Ethical challenges assessed in the clinical ethics committee of psychiatry in the region of Southern Denmark in 2010–2015: a qualitative content analyses. BMC Med Ethics. 2018; 19(1): 62.
Courtwright AM, Abrams J, Robinson EM. The role of a hospital ethics consultation service in decision-making for unrepresented patients. J Bioeth Inq. 2017; 14(2): 241-50.
Levine C. Questions and (some very tentative) answers about hospital ethics committees. Hastings Cent Rep. 1984: 14(3): 9-12.
Rasoal D, Skovdahl K, Gifford M, Kihlgren A, editors. Clinical ethics support for healthcare personnel: an integrative literature review. Hec Forum. 2017 ;29(4):313-346.
Rosner F. Hospital medical ethics committees: a review of their development. JAMA. 1985; 253(18): 2693-7.
Bollig G, Schmidt G, Rosland JH, Heller A. Ethical challenges in nursing homes–staff's opinions and experiences with systematic ethics meetings with participation of residents’ relatives. Scand J Caring Sci. 2015; 29(4): 810-23.
Cole M, Healey G. Doing the right thing! a model for building a successful hospital-based ethics committee in Nunavut. Int J circumpolar Health. 2013; 72.
Kadivar M, Mosayebi Z, Asghari F, Zarrini P. Ethical challenges in the neonatal intensive care units: perceptions of physicians and nurses; an Iranian experience. J Med Ethics Hist Med. 2015; 8: 1.
Orlowski JP, Hein S, Christensen JA, Meinke R, Sincich T. Why doctors use or do not use ethics consultation. J Med Ethics. 2006; 32(9): 499–502.
Fischer CT. Bracketing in qualitative research: conceptual and practical matters. Psychothe Res. 2009; 19(4-5): 583-90.
Mabuza LH, Govender I, Ogunbanjo GA, Mash B. African primary care research: qualitative data analysis and writing results. Afr J Prim Health Care Fam Med. 2014; 6(1):640.
Forde R, Pedersen R. Clinical ethics committees in Norway: what do they do, and does it make a difference? Camb Q Healthc Ethics. 2011; 20(3): 389-95.
Gharehbaghian A, Mehran M, Karimi G. Knowledge of hospital managers about the role of hospital transfusion committees and their activities. Hakim Health Systems Research Journal. 1384; 8(1): 35-42. [in Persin]
Hajibeigi B, Atarchi Z, Bahaeloo H, Assari S, Abbasian A. Performance of hospital blood transfusion committees in Tehran (2005-2006). The Scientific Journal of Iran Blood Transfusion Organization. 2007; 4(2): 137-42.
Forde R, Pedersen R, Akre V. Clinicians’ evaluation of clinical ethics consultations in Norway: a qualitative study. Med Health Care Philos. 2008; 11(1): 17-25.
Gaudine A, Lamb M, LeFort SM, Thorne L. Barriers and facilitators to consulting hospital clinical ethics committees. Nurs Ethics. 2011; 18(6): 767-80.
DuVal G, Clarridge B, Gensler G, Danis M. A national survey of U.S. internists’ experiences with ethical dilemmas and ethics consultation. J Gen Intern Med. 2004; 19(3): 251-8.
Larcher V, Slowther AM, Watson AR, UK Clinical Ethics Network. Core competencies for clinical ethics committees. Clin Med (Lond). 2010; 10(1): 30-3.
Amini H, Rezapour R, Delir Akbari Z, et al. Iranian medical residents’ professionalism: a peer assessment study. Clinical Ethics. 2020;15(1):17-22.
Mousavi MSS, Khodayari-Zarnaq R, Hajizadeh A. Main challenges in adoption of consultation services of hospital ethics committees: a systematic review of the literature. Clinical Ethics. 2021; doi:10.1177/1477750921994278
McGee G, Caplan AL, Spanogle JP, Asch DA. A national study of ethics committees. Am J Bioeth. 2001; 1(4): 60-4.
Youngner SJ, Jackson DL, Coulton C, Juknialis BW, Smith EM. A national survey of hospital ethics committees. Crit Care Med. 1983; 11(11): 902-5.
Asgaripour F, Mirrezaie S, Hajibeigi B, Chegini A, Sadegh H. Performance of hospital blood transfusion committees in Tehran 2008-2009. The Scientific Journal of Iranian Blood Transfusion Organization. 2012; 9(2): 132-9.
|Issue||Vol 14 (2021)|
|Ethics committees Medical ethics Professional ethics Ethical issues Qualitative research|
|Rights and permissions|
|This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.|