Determining the function of a hospital clinical ethics committee: making ethics work

The objective of this study was to identify ethical issues of greatest concern to hospital staff, and to establish perceptions regarding the optimal function of a Clinical Ethics Committee (CEC). The design involved a descriptive, cross-sectional study using a self-report questionnaire, which was sent to a random sample of medical, nursing, allied health, technical and administrative staff working at the John Hunter Hospital (a 650-bed, urban, teaching hospital in New South Wales) in September 1995. The questionnaires were sent to 565 staff and completed by 287: an overall compliance rate of 51%. Although the majority of staff supported the existence of the CEC in principle, approximately two-thirds were actually aware of its existence and less than 10% were aware of policies/guidelines produced by the CEC. Ethical issues of greatest concern to respondents were informed consent and confidentiality. Most believed that the main function of the CEC should be education and policy development; fewer supported a role in case consultation or case review, and even less believed that the CEC should take any role in resource allocation decisions. While there is a strong degree of support for the existence of a CEC, there is considerable variation in opinion regarding what should be its function and how it should be organized. The results of this study provide some insight into the issues associated with the emergence of CECs in an Australian context.