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Observations Ethics Man

The unpalatable truth about ethics committees

BMJ 2009; 339 doi: (Published 14 October 2009) Cite this as: BMJ 2009;339:b4179
  1. Daniel K Sokol, honorary research fellow in medical ethics, Imperial College London
  1. daniel.sokol{at}

    Clinical ethics committees are ill suited to resolving the individual ethical problems of clinicians at the coalface

    My pathological inability to say “no” has carried a high price. I sit on 10 committees, including clinical ethics committees (CECs). In 2005 the Royal College of Physicians noted that “wherever healthcare is provided we believe that there will be a need for formal ethics support which is both timely and informed.”1 The United Kingdom now has more than 70 CECs. Their role varies from institution to institution, but most of them review hospital policies and provide advice on ethically problematic cases. The idea is wonderful; the reality quite different.

    After anecdotal reports of inactivity, some colleagues and I recently published a study in the Postgraduate Medical Journal on the case consultation activities of CECs in the UK.2 We sent an anonymous questionnaire to chairpersons of 70 CECs. Thirty completed the questionnaire. The results were worrying: although all the respondents said that their committee welcomed individual cases, 10% had not considered a single active (or “live”) case in the past 12 months, 43% had …

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