Making the Case for a Clinical Ethics Service

  • Supporting clinical decision-making. Clinical ethics services can support clinical decision-making, by ensuring that is attentive to the relevant ethical aspects. It is important to note that such services are advisory – ultimate decision-making authority remains with the relevant clinician, in consultation with the patient and other appropriate stakeholders. As such, clinical ethics services are advisory and supportive; they do not interfere with clinical autonomy. For such reasons, some services prefer to label themselves as Clinical Ethics Advisory Groups.
  • Reinforcing the organisation’s ethical culture. Various official inquiries and legal proceedings have highlighted the importance of attending to ethical considerations in clinical care. When incorporated into the governance structure of the host organisation, formal clinical ethics support provides a mechanism for the organisation to transparently and systematically address ethical challenges arising from clinical practice.
  • Fostering trust amongst the public, patients and other stakeholders. Regulators, such as the General Medical Council, refer to the importance of fostering and maintaining the trust of patients and other stakeholders. It is conceivable that the existence of a clinical ethics service will help to foster the confidence and trust of the public, patients, and other service users.
  • Improving patient well-being and satisfaction. The existence of a clinical ethics service within an organisation can promote positive patient perceptions of the organisational approach to the provision of clinical care. A service may also help to improve patient outcomes and well-being, for example, by promoting clinical care that is aligned with the interests and wishes of patients.
  • Improving staff well-being. The ethically challenging aspects of patient care can, in some cases, cause staff to endure moral distress or moral injury, and leave them with a moral residue. These can, in turn, lead to further adverse effects, such as compassion fatigue, avoidance of similarly challenging scenarios, burnout, and exit from the profession. Since a clinical ethics service provides a forum for openly addressing the ethical aspects of healthcare, it is conceivable that this can help to address moral distress and thereby improve staff well-being.
  • Reducing or removing conflict. A clinical ethics service may be able to help address – and hopefully resolve – disagreements and disputes. Clinical ethics services might not be explicitly configured or intended to provide conflict resolution, but they may well be involved in disputed matters (such as in case consultation). Although some disputes might lead to complaints or legal action, a clinical ethics service may help to avoid such outcomes.
  • Saving the organisation (or system) money. A clinical ethics service aims to ensure that due account is given to the ethical aspects of healthcare, for example, by providing input into individual patient care, relevant policies adopted in the organisation, and the education of colleagues. Through such input, the service may be able to help reduce complaints and legal proceedings, which can otherwise be costly, both emotionally and financially.

We partner with the Institute of Medical Ethics (IME), an organisation which is dedicated to improving education and debate in medical ethics. Visit the IME website