Sammanfattning
BACKGROUND: All health trusts in Norway have a clinical ethics committee (CEC). What general issues do the committees address, and how do they take the patient’s perspective into account?
MATERIAL AND METHOD: We sent a questionnaire survey to Norway’s 38 clinical ethics committees in spring 2016, and received answers from 34 (89 per cent response rate).
RESULTS: The 34 committees that took part in the survey discussed 322 cases in the period 2014–2015. Half of them reported that they invited patients and patients’ families to take part in the discussions. Many committees had a high level of activity, while others had few cases. They also arranged staff seminars on ethics, and most stated that they took part in the work of drawing up guidelines. A third of the committees reported that they were not sufficiently rooted in the management of the health trust, and/or experienced that access to resources placed constraints on their work. About half expressed a need for more expertise, for example in clinical ethics and law. Recurring topics in the general issues that were discussed were the use of coercion, confidentiality, communication and coordination, together with priority setting and resource use.
INTERPRETATION: Clinical ethics committees are important arenas for taking up issues relating to ethical values in everyday clinical practice, including the matter of resources. Some of the committees could potentially be used more, and several should attempt to include patients and their families in discussions more often.