Education And Debate

Development of clinical ethics committees

BMJ 2004; 328 doi: (Published 15 April 2004) Cite this as: BMJ 2004;328:950
  1. Anne Slowther, research fellow (,
  2. Carolyn Johnston, Clinical ethics network project officer1,
  3. Jane Goodall, Clinical ethics network administrator1,
  4. Tony Hope, director1
  1. 1Ethox Centre, Institute of Health Sciences, Oxford OX3 7LF
  1. Correspondence to: A Slowther
  • Accepted 9 February 2004

Support for dealing with ethical issues in clinical practice should be an integral part of patient care

Clinical practice raises a wide variety of ethical issues that can be difficult for individual doctors to resolve. Some NHS trusts have established clinical ethics committees to provide ethical support. These committees had largely worked alone until a meeting of committee representatives in January 2001 led to the development of the UK Clinical Ethics Network. The principal aims of the network are to promote the development of clinical ethics support in the United Kingdom, to encourage a high level of ethical debate in clinical practice, and to facilitate sharing of best practice between clinical ethics committees (box 1).1 We consider the emergence of clinical ethics support in the context of similar development in other countries.

What is clinical ethics support?

Clinical ethics support can be described as the provision of support and advice to health professionals and patients on ethical issues arising from clinical practice or patient care. The support can take different forms, but in the United Kingdom the most common model is a committee or group sitting within an NHS trust, usually an acute trust. These committees are multidisciplinary and include lay members. Issues are referred to the committee by clinicians and managers, and some committees are now being approached by local general practitioners. Few committees include patients or their families directly in committee discussions.

The number of trusts with clinical ethics committees is increasing. In 2001 the Nuffield Trust published a survey of all NHS trusts that identified 20 …

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