The Australian Health Ethics Committee (AHEC) of NHMRC has developed this consensus statement to highlight
- the importance of clinical ethics services for the delivery of quality healthcare in Australia and
- the need to develop national resources and guidance in this area.
The provision of high quality health care is of utmost importance to Australians. State and Territory governments and the Commonwealth strongly support its provision. Health care should meet the needs of the community and be delivered in a just and equitable manner in accordance with accepted ethical principles.
Interactions between patients and health care professionals are at the heart of health care. These interactions have an essential ethical dimension that may at times be challenging. Supporting professionals and organisations to meet those challenges can help ensure that patient care is provided in an ethically appropriate manner.
The central role of clinical ethics services in promoting quality improvement in the delivery of health care is recognised by accreditation programs1,2, some of which require health services to have explicit processes or structures in place for dealing with ethical issues arising in the clinical context. As such, the establishment and maintenance of clinical ethics capacity in hospital, community-based and other clinical settings is a core function of health services.
Currently, clinical ethics services exist in a small number of larger public and private hospitals. These services generally provide access to clinical ethics committees for case consultation (in real time or retrospectively), input into hospital policy and guideline development and/or the provision of staff training and education. However, their development, role, terms of reference and level of resourcing are highly variable.
AHEC recommends the development of nationally consistent guidelines for clinical ethics services. A national approach will help to ensure that clinical ethics services are effective, valued, sustainable and integrated into systems supporting the delivery of quality health care. Such guidance will:
- assist and encourage health care organisations in establishing and resourcing clinical ethics services that support clinical practice and quality improvement
- help institutions to meet accreditation requirements, and
- ensure the design and delivery of health care appropriate to the needs and values of the Australian community.
1 National Safety and Quality Health Service Standards (NSQHS). Standard 1. Governance for Safety and Quality in Health Service Organisiations.
2 For example, see Equip National Guidelines. Standard 15. Criterion 2. 15.6. The Australian Council on Healthcare Standards, pp16-17 (2012).