Team members perspectives on conflicts in clinical ethics committees

Area of Science:

• Healthcare Management
• Medical Ethics
• Organizational Psychology

Background:

• Clinical ethics committees (CECs) are widely implemented in healthcare settings.
• Mandatory evaluation is crucial for ensuring the quality of ethics consultations.

Purpose of the Study:

• To evaluate the perspectives of all stakeholders involved in CEC implementation.
• To assess the process of implementing CECs on hospital wards.

Main Methods:

• Non-participating observation of four ethics case consultations.
• Open-guided interviews with 28 participants.
• Grounded theory for data analysis.

Main Results:

• Communication problems and hierarchical team conflicts are primary drivers for ethics consultations.
• Hierarchical asymmetries within medical teams exacerbate these conflicts.
• Participants perceived that CECs often maintain existing hierarchies rather than resolving them.

Conclusions:

• CEC structures can reflect and perpetuate institutional hierarchies, hindering their effectiveness.
• Disagreements among caregivers are significant ethical challenges that CECs must recognize.
• Integrating nurses and physicians in case presentations can improve interpersonal dynamics and perspectives.