Hospital bioethics committees: importance, operation and difficulties in implementation

Sayago, Mariana; Amoretti, Rogério

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Research • Rev. Bioét. 29 (4) • Oct-Dec 2021 • https://doi.org/10.1590/1983-80422021294517 copy

Hospital bioethics committees: importance, operation and difficulties in implementation

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Created in the 1960s, hospital bioethics committees help solve ethical health conflicts, ensuring the protection of the patients’ human dignity. The aim of this article is to investigate the importance and operation of such committees in supporting patients, family members, hospital staff and health institutions in the face of bioethical challenges. A systematic literature review was carried out in the SciELO and PubMed databases between January and March 2021. The review showed the importance of hospital bioethics committees for the protection of human rights, through their support for autonomy and shared decision making in health issues, which can transform local corporate culture. The establishment and mandatory nature of ethics committees vary according to the country, with no established international standards. In Brazil, the absence of legal regulation is due to the lack of knowledge on the subject. This study aims to contribute to the advancement of regulations of hospital bioethics committees in the country.

Bioethics; Ethics committees; Vulnerable populations

Author(s)	Year of publication	Country	Database	Topic	Summary
Perin¹⁴	2020	Italy	SciELO	Importance	Clinical ethics committees must be implemented in health care institutions to promote a change in attitude and a commitment to place people as the central axis of health care in daily clinical practice. The decision making process must be inclusive, educational, respectful of cultural values and supportive of institutional efforts aimed at quality improvement and appropriate resource use.
Rabadán, Tripodoro¹⁹	2017	Argentina	SciELO	Importance	Bioethics committees must face the educational and consultative challenge of promoting ethical awareness in shared and democratic decision making through interdisciplinary, intersectional and intergenerational dialogue, encouraging the building of values by their members. The committee’s normative role is altered and the need for judicial control is reduced, as decisions are made through a transparent process respectful of human rights and fundamental freedoms.
Pitskhelauri²⁵	2018	United States	PubMed	Importance	The Netherlands, Belgium, Italy, Norway and the United Kingdom increasingly use clinical ethics committees to address new ethical dilemmas, strengthening the trend towards shared responsibilities based on patients’ autonomy, plurality, rights and dignity in decision-making, in a shift away from the physician’s single obligation in this process.
Moon²⁶	2019	United States	PubMed	Operation	Institutional ethics committees are important in the education of health professionals, staff members and patients, and committee members require continuing training, allowing the development and review of institutional policies related to ethical issues in patient care, conforming to the principles of fairness and confidentiality.
Oliveira, Oliveira and Martins²¹	2017	Brazil	SciELO	Operation	The article describes the experience of the bioethics committee in a Brazilian state public hospital and argues for the importance of encouraging the creation of such forums in the country’s health institutions.
Rasoal and collaborators²⁷	2017	Sweden	PubMed	Operation	Integrative review of clinical approaches to support health care personnel in the face of ethically difficult situations. It concludes that there is no universal standard for the operation of committees in clinical practice.
Carrillo-González, Lorduy-Gómez and Muñoz-Baldiris¹⁶	2019	Colombia	SciELO	Operation	The study surveys bioethics committees in Colombia and finds that committees on the country’s Atlantic coast have as their primary function education in ethical and bioethical issues, followed by specific activities of each committee, and that some do not have well-defined functions. The article advocates establishing standards to make them more effective in health institutions.
Ledesma and colaborators²⁸	2015	Argentina	SciELO	Operation	The article presents the experience of a public pediatric hospital’s ethics committee in Buenos Aires created in 1994. Among the main considerations for satisfactorily meeting its demands, we highlight the reduction in formality for case presentation, parental consent form for discussing cases in the committee and the inclusion of the committee’s recommendations in the patients’ clinical history.
Woellert²⁹	2019	Germany	PubMed	Importance	Committees can assist in the implementation of organizational clinical ethics through consultancy, training and institutional policy development, making it an integral part of the corporate culture.

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E-mail: bioetica@portalmedico.org.br

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[1] Correspondence: Mariana Calefi – SQN 211, bloco I, apto. 102 CEP 70863-090. Brasília/DF, Brasil.