Objectives: To quantify the presence, purpose, function, governance and funding of clinical ethics services (CES) in tertiary paediatric hospitals in Australia and New Zealand.
Design setting and participants: A descriptive, quantitative survey was conducted across eight paediatric hospitals.
Main outcome measures: Responses from survey questions on the presence, purpose, function, governance and funding of the CES.
Results: Seven of eight tertiary paediatric hospitals identified access to CES. Regarding purpose and function, all CES provided clinical case consultation, six of seven provided education and training, six of seven assisted with organisational policy and guideline development and four of seven undertook original ethics research. There was wide variation in how case consultations were conducted, reported and documented. With respect to governance and funding, all CES reported to their hospital executive and only one CES reported having a dedicated, although small, budget.
Conclusions: Heterogeneity in the process of case consultation and CES policy content exists across the organisations studied. There is consistency with the broader values that underpin CES such as their multidisciplinary nature and level of training required for key staff. There is an apparent lack of formal budgetary support from health services for CES activities, with support derived mostly from staff who contribute their time in addition to their primary roles.
Keywords: clinical ethics; clinical ethics advisory group; clinical ethics response group; clinical ethics services; health service; paediatric.
Conflict of interest statement
Competing interests: None declared.
Antimicrobial stewardship resources and activities for children in tertiary hospitals in Australasia: a comprehensive survey.Med J Aust. 2015 Feb 16;202(3):134-8. doi: 10.5694/mja13.00143. Med J Aust. 2015. PMID: 25669475
Evaluation of a paediatric clinical ethics service.J Paediatr Child Health. 2018 Nov;54(11):1199-1205. doi: 10.1111/jpc.13933. Epub 2018 May 10. J Paediatr Child Health. 2018. PMID: 29746009
Role and function of a paediatric clinical ethics service: experiences at the Royal Children's Hospital, Melbourne.J Paediatr Child Health. 2011 Sep;47(9):632-6. doi: 10.1111/j.1440-1754.2011.02171.x. J Paediatr Child Health. 2011. PMID: 21951448
Characteristics of Indigenous primary health care models of service delivery: a scoping review protocol.JBI Database System Rev Implement Rep. 2015 Nov;13(11):43-51. doi: 10.11124/jbisrir-2015-2474. JBI Database System Rev Implement Rep. 2015. PMID: 26657463 Review.
Integration and continuity of primary care: polyclinics and alternatives – a patient-centred analysis of how organisation constrains care co-ordination.Southampton (UK): NIHR Journals Library; 2015 Aug. NIHR Journals Library. 2015. PMID: 26312365 Free Books & Documents. Review.
Cited by 1 article
How to read an ethics paper.J Med Ethics. 2018 Dec;44(12):810-813. doi: 10.1136/medethics-2018-104997. Epub 2018 Aug 22. J Med Ethics. 2018. PMID: 30135108 Free PMC article.
- The Australian Council on Healthcare Standards (ACHS). EQuIPNational guidelines standard 15. Sydney Australia: ACHS, 2012.
- Royal College of Physicians of London. Ethics in practice: background and recommendations for enhanced support. Wiltshire: Royal College of Physicians, 2005.
- Australian Health Ethics Committee. AHEC consensus statement on clinical ethics. Canberra (AU): National Health and Medical Research Council, 2015:1 https://www.nhmrc.gov.au/health-ethics/ethical-issues-and-further-resources/ahec-consensus-statement-clinical-ethics (accessed 22 Apr 2016).
- UK Clinical Ethics Network. Core competencies for clinical ethics committees: a consensus statement from the UK clinical ethics network. 2007:10 http://www.ukcen.net/uploads/docs/education_resources/core_competencies1.pdf (accessed 22 Apr 2016).
- Joint Commission on Accreditation of Healthcare Organizations. Accreditation manual for hospitals. Oakbrook Terrace, IL: Joint Commission on Accreditation of Healthcare Organizations, 1993. Cited by Slowther A, Hope T. Clinical ethics committees: they can change clinical practice but need evaluation. BMJ 2000;312:649-650.