Exploring the Use of a Clinical Ethics Service in an NHS Trust

Background

At work, healthcare professionals regularly experience ethical dilemmas such as issues around capacity and consent, withdrawing treatment and making treatment decisions. To cope with such issues, clinicians utilize a variety of methods including individual reflection, discussions with colleagues or discussions at departmental meetings. However, more formal support services have been developed, such as clinical ethics forums. These exist in different forms internationally. In this specific NHS Trust, forum members include doctors, nurses, ethicists and lay members and it functions to provide ethical advice to clinicians regarding their dilemmas. Other roles of the forum are to provide ethical education and to consider Trust policies from an ethical perspective.

Methods

This aims of this research were to explore the use of the clinical ethics forum at the Trust from the perspectives of its users (clinical staff) and forum members, using a mixed methods approach (semi-structured interviews and a survey).

Results

The majority of healthcare professionals surveyed were aware of the existence of the clinical ethics forum, but the majority had not used it. Forum members described an underutilization of the forum; their perception was that the forum had a low profile within the Trust. Challenges included maintaining forum membership and a lack of protected time to deliver a satisfactory service. Barriers to the use of the forum were explored and suggestions were made as to how to increase clinician engagement with the forum, the most remarkable being to improve the profile of the forum and to provide a more timely and quality assured service.