Abstract
Clinical Ethics Committees (CECs), as distinct from Research Ethics Committees, were originally established with the aim of supporting healthcare professionals in managing controversial clinical ethical issues. However, it is still unclear whether they manage to accomplish this task and what is their impact on clinical practice. This systematic review aims to collect available assessments of CECs’ performance as reported in literature, in order to evaluate CECs’ effectiveness. We retrieved all literature published up to November 2019 in six databases (PubMed, Ovid MEDLINE, Scopus, Philosopher’s Index, Embase and Web of Science), following PRISMA guidelines. We included only articles specifically addressing CECs and providing any form of CECs performance assessment. Twenty-nine articles were included. Ethics consultation was the most evaluated of CECs’ functions. We did not find standardized tools for measuring CECs’ efficacy, but 33% of studies considered “user satisfaction” as an indicator, with 94% of them reporting an average positive perception of CECs’ impact. Changes in patient treatment and a decrease of moral distress in health personnel were reported as additional outcomes of ethics consultation. The highly diverse ways by which CECs carry out their activities make CECs’ evaluation difficult. The adoption of shared criteria would be desirable to provide a reliable answer to the question about their effectiveness. Nonetheless, in general both users and providers consider CECs as helpful, relevant to their work, able to improve the quality of care. Their main function is ethics consultation, while less attention seems to be devoted to bioethics education and policy formation.
Highlights
Clinical Ethics Committees (CECs) or Hospital Ethics Committees are bodies originally established with the aim of supporting healthcare professionals in managing controversial ethical issues affecting clinical practice (Fleetwood et al 1989) that cannot be settled in terms of medicalCECs deliver ethics support in many ways, by undertaking a variety of tasks that, over time, scientific literature has categorized as follows: ethics consultation, policies formation and/or revision, and bioethics education (Aulisio and Arnold 2008)
CECs developed in parallel with Research Ethics Committees (RECs), CECs are much less enforced and their tasks are much less harmonized
The string was built in relation to two semantic groups: group A included all possible definitions and mesh terms related to CECs; group B contained all terms pertaining to assessment, impact, and/or evaluation
Summary
Clinical Ethics Committees (CECs) or Hospital Ethics Committees are bodies originally established with the aim of supporting healthcare professionals in managing controversial ethical issues affecting clinical practice (Fleetwood et al 1989) that cannot be settled in terms of medicalCECs deliver ethics support in many ways, by undertaking a variety of tasks that, over time, scientific literature has categorized as follows: ethics consultation, policies formation and/or revision, and bioethics education (Aulisio and Arnold 2008). Clinical Ethics Committees (CECs) or Hospital Ethics Committees are bodies originally established with the aim of supporting healthcare professionals in managing controversial ethical issues affecting clinical practice (Fleetwood et al 1989) that cannot be settled in terms of medical. CECs developed in parallel with Research Ethics Committees (RECs) (or Institutional Review Boards, as labelled in the US), CECs are much less enforced and their tasks are much less harmonized. Since their first appearance in the late 1970, CECs and the other forms of ethical support services have grown up.
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