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14 HEC F. 1 (2002)

handle is hein.journals/hecforum14 and id is 1 raw text is: H E C FOR UM © 2002 Kluwer Academic Publishers. 2002; 14(1):1-3. Printed in The Netherlands. EDITORS' INTRODUCTION THE DEVELOPMENT OF HEALTHCARE (CLINICAL) ETHICS COMMITTEES IN THE U.K. ANNE SLOWTHER, MRCGP, M.A. JOHN McMILLAN, Ph.D. During the last five years, U.K. healthcare (clinical) ethics committees (CECs) have become a much more common phenomenon. A recent study conducted by ETHOX at the University of Oxford and funded by the Nuffield Trust, identified twenty such committees in U.K. National Health Service (NHS) trusts (individual hospitals or organizations providing NHS healthcare) (1). This corresponds to about 4% of such trusts, but since the study many more NHS trusts have either established or are considering establishing such a committee. Most of the committees in the U.K. have developed because of the concerns of individual clinicians about difficult ethical decisions that they have faced in their clinical practice. However, recent high-profile cases of poor ethical practice in some hospitals make it likely that there will be pressure from local and national health service management to introduce some form of CEC within NHS trusts in the future. U.K. CECs differ in the emphasis placed on individual functions of the committee, but the three main functions of these committees mirror those in North America, namely education, guideline and policy formation and case review/consultation. Many of the structural questions considered by North American HECs are now being debated in the U.K. These questions include the nature of education for committee members, the appropriate membership for committees and the prospect that committees might be regulated by a national structure or set of guidelines. CECs have also been developing in Europe. In some countries clinical and research ethics committees (RECs) are combined but in the U.K. they have developed separately. RECs are centrally regulated and their terms of reference only cover research issues. The Nuffield Trust study on clinical ethics committees also looked at the possible role of research ethics committees in clinical ethics support. A few RECs had been asked for advice on borderline issues such as the use of unlicensed drugs and innovative treatments, but the consensus was that RECs were not constituted to address clinical ethical issues and their workload was too great to allow them to do so. The following collection of papers extends the discussion about these 1

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