What are Clinical Ethics Committees?

Clinical ethics committees - CEC's- (also known as clinical ethics groups or forum) are multidisciplinary groups, including health professionals and lay members that aim to provide support for decision-making on ethical issues arising from the provision of patient care within NHS Trusts and other health care institutions. They have only recently begun to develop in the UK although similar committees are common in North America and are also found in some European countries.

In 2000 there were 20 such committees in the UK and there are now 85 committees or groups known to the Network. The structure of the committee, the functions it performs and its position within the Trust varies between committees, as each has developed in the context of the particular needs and resources of the institution.

A survey of clinical ethics committees in the UK, carried out by the Network in 2002, gave a snapshot of the position in the UK at that time.

• The largest CEC had 26 members, and the smallest 6 members. On average the number of members of a CEC was 13.
• A wide variety of people sit on CEC's. The majority of members have a medical or nursing background but more than half of the CEC's we surveyed also have a legal member, lay and religious representation.
• Most CEC's meet monthly
• Committees have varied functions:
  • 54% frequently contribute to Trust policies and guidelines
  • 20% frequently interpret national guidelines
  • 37% frequently provide ethical education within the Trust
  • 66% frequently provide ethical support to clinicians

• CEC's discuss a variety of issues that arise in clinical settings, these include:
• Withholding and withdrawing treatment
• Do Not Resuscitate Orders
• Advance Directives
• Consent
• Capacity
• Refusal of treatment
• Confidentiality

Other forms of ethics support

Although the number of NHS Trusts with a clinical ethics committee is increasing, many Trusts do not have access to a committee. Some Trusts have access to ethics support through an ethics discussion forum or an individual clinical ethicist. Other sources of support for patients and health professionals on these issues would include:

Trust chaplains of all denominations and religions

Patient support organisations - see useful links 

Professional organisations - see links to ethics committees