You are here: HomeEducational ResourcesSupport GuideAppendices → Appendix A2

Educational Resources: Appendices

Appendix A2

Clinical ethics committees in German Hospitals

Dr Thela Wernstedt, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany

Clinical Ethics Committees (CECs) are new institutions of implementing clinical ethics in German hospitals and nursing homes. Most of the CECs are in hospitals that are members of the Protestant or Catholic Hospital Association, which recommended in 1997 the founding of CECs. There are CECs at only three University Hospitals: Hanover (2000), Erlangen (2002) and Mannheim (2004). Another three have ethics consultation without a CEC: Marburg, Ulm, Freiburg. There are some communal and confessional hospitals wich have active CEC or ethics consultation or other forms of ethical support (Hamburg, Hanover, Göttingen, Frankfurt and Nuremberg). Altogether there were 77 CECs in German hospitals in 2003.

In 2002 we posted a questionnaire with 13 items to medical directors and directors of nursing of all 36 German University Hospitals to find out why so few University hospitals have CECs.

We found, that the most relevant ethical issues in everyday clinical practice were limitation of treatment, informed consent and the conflict between beneficence and autonomy. Improvement of interdisciplinary teamwork, further education in ethics and improvement of guidelines have been identified in order to improve ethical professional performance. Additional support of their staff in ethical issues was mentioned by more directors of nursing than medical directors and also the regret about the low priority that ethical issues have in everyday patient care.

Five German University Hospitals are planning to establish a CEC, another two want to employ a clinical ethicist. There is high need for information about CECs in German university hospitals. Tasks, working methods and chances for further development of CECs are neither known nor used by the majority of German University Hospitals.

Literature

 

  1. Deutscher Evangelischer Krankenhausverband, Katholischer Krankenhausverband Deutschlands. Ethik-Komitee im Krankenhaus. 1. Auflage (Hrsg.). Stuttgart Freiburg: Selbstverlag 1997.
  2. Deutscher Evangelischer Krankenhausverband, Katholischer Krankenhausverband Deutschlands. Ethik-Komitee im Krankenhaus. Erfahrungsberichte zur Einrichtung von Klinischen Ethikkomitees. 1. Auflage (Hrsg.). Stuttgart Freiburg: Selbstverlag 1999.
  3. Gerdes B, Richter G. Ethik-Konsultationsdienst nach dem Konzept von J.C. Fletcher an der University of Virginia. Charlottsville, USA. Ethik Med 1999; 11: 249-261.
  4. Kettner M, May A. Landkarte Klinische Ethikkomitees in Deutschland. Unveröffentlichtes Manuskript, 2003.
  5. Neitzge G. Ethik im Krankenhaus: Funktion und Aufgaben eines Klinischen Ethikkomitees. Ärzteblatt Baden-Württemberg 2003; 4: 175-178.
  6. Reiter-Theil S. Ethik in der Klinik- Theorie und Praxis: Ziele, Aufgaben und Möglichkeiten des Ethik-Konsils. Ethik Med 1999; 11: 222-232.
  7. Simon A. A Report from a Catholic hospital- Neu Maria-Hilf, Göttingen. HEC Forum 2001; 13: 232-241.
  8. Simon A. Ethics Committees in Germany: An empirical survey of Christian Hospitals. HEC Forum 2001; 13: 225-231.
  9. Wernstedt T. Strukturen der Medizinethik in Deutschland, Teil 1 und 2 in Bayr. Ärzteblatt 1/2004: 69 und 5/2005:313.
  10. Vollmann J, Weidtmann A. Das Klinische Ethikkomitee des Erlanger Universitätsklinikums. Institutionalisierung – Arbeitsweise – Perspektiven. Ethik Med 2003; 15:229-238.
  11. Vollmann J, Burchardi N, Weidtmann A. Klinische Ethikkomitees an deutschen Universitätskliniken. Eine Befragung aller Ärztlichen Direktoren und Pflegedirektoren. Dtsch Med Wochenschr 2004; 129:1237-1242.

Copyright of Appendix A2 is held by Dr Wernstedt.

Dr Thela Wernstedt
Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany
Medical Doctor
Magistra Atrium for Philosophy
Anesthesiologist
Chair, Clinical Ethics Committee
Ethics Consultant