Clinicians need better access to ethics advice, report says

Health professionals should have access to ethics support at a local level and be able to ask for advice on ethical dilemmas 24 hours a day, a report from the Royal College of Physicians has recommended this week.

The report recommends that healthcare institutions should review their existing arrangements for providing support on ethics and develop and implement guidelines on how to recognise and handle advice on ethical issues.

This should be done by an identified lead individual working with others and with the full support of management. Centres at which complex dilemmas often occur should consider setting up a clinical ethics committee if they do not already have one.

The report is based on the findings of a working party that was set up to examine the need for local support for ethical judgment in clinical practice in response to the growing numbers of ethical uncertainties that health professionals reported facing on a daily basis. After reviewing a wide range of evidence, the working party warned, “Current provision of ethics support is uneven and often depends upon the enthusiasm of individuals.” It recommended that ethics support was needed wherever health care is provided, with a local clinical ethics committee or arrangements for informal advice from seniors and peers, supplemented by national sources of advice (such as the BMA Ethics Unit).

Michael Parker, professor of bioethics and director of the Ethox centre at the University of Oxford, who drafted the report on behalf of the working party, said, “Health professionals are increasingly recognising the need for access to appropriate forms of ethics support and advice to help them with their day to day practice.” He said that the call for greater access to advice on ethical issues came largely from health professionals themselves.

The report included the results of a survey of 1146 specialist registrars which found that a third said that they had received no ethics training.