Supporting primary care with ethics advice and education

Implications of clinical ethics support and clinical ethics committees for primary care trusts

It would be a pity to miss an early opportunity to consider how to build clinical ethics support into the structure of the new primary care groupings in the United Kingdom. Neither standard ethical precepts nor guidelines from national bodies like the General Medical Council1 or the British Medical Association2 can cover all the intricacies and nuances of any given clinical situation. Best practice requires the interpretation and application of ethical principles in the local context, so primary care trusts will have to recognise, as acute trusts have started to do, that they have a responsibility to support clinicians and managers alike as ethical problems arise in their day to day work.

Primary care can draw on experience of clinical ethics support in secondary care, as well as on international experience, which is collated in a recent Nuffield Trust report on the subject3 and was the subject of a recent conference in London. Some 20 hospital trusts in the United Kingdom now have clinical ethics committees, which may help to bridge the interprofessional gap arising from different backgrounds in ethics approaches. Other trusts …