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EDUCATION AND DEBATE: Ana Borovecki, Stjepan Oreskovic, and Henk ten Have Ethics and the structures of health care in the European countries in transition: hospital ethics committees in Croatia BMJ 2005; 331: 227-229 [Full text]

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Pain of transition and ugliness of imitation

Vasiliy Vlassov   (22 July 2005)

Role of ethical committee (EC) in protecting patient privacy

Ozren Pestic   (28 July 2005)

Pain of transition and ugliness of imitation 22 July 2005
Vasiliy Vlassov, Director Russian Branch of the Nordic Cochrane Centre Send response to journal: Re: Pain of transition and ugliness of imitation	Ethics committees in Russia are going through the similar deviated development. The research ethics committees were first introduced in the eighties at the request of foreign counterparts in biomedical research. In research facilities where this demand was met seriously, the oldest scientists chaired the committees. Unfortunately in hospitals, where approval of trials' protocols by committees was the main external request, these committees were fictitious, created ad hoc just to sign the approval papers. Despite ethics committees being enshrined in basic law on health care in Russia in 1993, still Ministry of Health uses the committee attached to the Ministry as an additional mechanism of influence on the clinical trials' management. In hospitals the ethics commettees start to emerge in last four years only. I possess the collection of 'consent' forms offered to patients in Russian hospitals. In most of these forms the most important statement is that patient understands that after signing the document s(he) will not complain about the quality of service. Still the hospital ethics committees do not manange the living will (practice almost not known in Russia as yet) and the do not resuscitate orders. Of course, this underdevelopment of ethics committees is only the symptom of unethical medical practice. Unfortunately in the new totalitarian state the development of these instruments of society and the medical profession is not welcomed. Competing interests: None declared
Role of ethical committee (EC) in protecting patient privacy 28 July 2005
Ozren Pestic, Chief of Informatics Department General Hospital Zadar, Croatia Send response to journal: Re: Role of ethical committee (EC) in protecting patient privacy	I would like to adress some observations about the role of ethical committees (EC) in hospitals. ECs, among other roles, can find its place in protecting privacy of patients, especially in hospitals where Electronic Medical Record (EMR) is introduced. Talking from our experiences, hospital EC was involved while we were discussing how to implement privacy policy in our information system (IS) , where EMR is a core concept. From this work, privacy policy document was born where we emphasized the importance of ethical committee in protection of privacy of patients. Although EC has only the advisory function, its opinion while bringing regulation policies, is inevitable. The role of EC on the national level is even more important for coordinating such activities on national level. It would be unacceptable that every hospital brings its own policy , in protecting privacy, for example. This initiatives should be supported by national EC, enforcing some basic principles, but formulated in a way that are appropriate for everyday practice. Competing interests: None declared