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Practical Guide to Clinical Ethics Support

Section B: UK clinical ethics Network

Introduction

In January 2001, 20 representatives of clinical ethics committees in NHS trusts met to discuss the future development of clinical ethics committees (CECs), and other forms of clinical ethics support, in the UK. This meeting prompted the development of the UK Clinical Ethics Network. The Network provides information and support for those involved in setting up CECs and for established CECs.

UK Clinical Ethics Network – who’s who:

The Network Committee

Chair - Dr Alan Watson, Director of the Children and Young People’s Kidney Unit at Nottingham City Hospital.

Vice Chair - Dr Stephen Louw, Clinical Director for General Medicine and Care of the Elderly Services at the Freeman Hospital in Newcastle upon Tyne.

The 11 other Network Committee members are chairs and representatives of CECs from across the UK covering a wide range of clinical specialities.

The remit of the Network Committee is to consider the aims, objectives and future development of the Network. It holds an annual general meeting for all members of the Network.

Network Support Project: Run by the Ethox Centre, University of Oxford

Dr Anne Slowther is supervising the development of the Network Support Project. Anne is also a GP and a Senior Lecturer in Clinical Ethics at Warwick Medical School.

Andy Cooper is the Clinical Ethics Support Project administrator.

The objectives of the UK Clinical Ethics Network are to:

  • Offer support and advice to developing and established clinical ethics groups
  • Provide networking facilities including a newsletter, electronic mailing and network website
  • Facilitate training for members of clinical ethics groups
  • Support regional initiatives
  • Organise an annual conference
  • Produce a database of useful and relevant information for clinical ethics groups
  • Establish links with clinical ethics groups internationally

Support the Network can offer:

Newsletter

The Network newsletter is distributed three times a year to Chairs of CECs known to the Network and to individual members (where details have been supplied). Topical issues are dealt with on an occasional basis and have included Assisted Conception (Spring 2003), processes adopted by CECs and the Data Protection Act 1998 (Autumn 2003) and the Human Tissue Bill / Organ donation (Summer 2004). Click here to view the latest newsletter.

Network facilitation

The Network facilitates the sharing of information between clinical ethics committees through the electronic database of members. This often takes the form of an enquiry for information from a clinical ethics committee. The Network circulates this request to all members of the Network by email. Replies are collated and, together with additional information on the subject identified and summarised by the support team, form a brief discussion document that is sent to the requesting CEC and all CECs who responded to the request. Some of these summaries are published in the Network Newsletter.

Topics that have arisen for discussion / clarification include;

  • Rationing of services due to lack of staff
  • Ethical scrutiny of management decisions
  • Developing a framework for ethical discussions
  • Patients access to minutes of CEC meetings
  • Medical student interaction with patients
  • Committee membership and terms of office
  • Service users sitting on mental health CECs
  • Use of drugs of porcine origin
  • Neonatal circumcision for religious reasons
  • Developing a Do Not Attempt Resuscitation policy
  • Case Consultation and Access to Minutes
  • Electronic Tagging of Vulnerable Patients

Annual conference

Since 2001 the Network has organised a conference on clinical ethics in conjunction with an individual host CEC. The aim of the conference is to stimulate interest and discussion in clinical ethics and focuses on examples of the work of clinical ethics committees in the UK. Practical consideration of case studies has been a major part of the conference. The fourth annual conference, held in London in May 2004, focussed on end of life issues and included a European perspective with presentations from Germany and the Netherlands. The 2005 conference, to be held in Newcastle, will look at the issues of resource allocation.

Website

The Network website was launched in September 2003. The aim of the website is to provide relevant information that is easily accessible for CEC members, clinicians and patients.

It provides:

  • Contact details for all CECs known to the Network and, where relevant, topics that the CEC has frequently considered and whether it has drafted / provided input into trust policy or guidelines
  • Worked through hypothetical case studies
  • Ethical and legal discussion of topical issues including Consent and Refusal of Treatment, Patient Confidentiality, End of Life issues and Resource Allocation
  • Examples of frameworks for ethical discussion
  • Links to national guidelines and a glossary of terms
  • Commentaries and perspectives on ethical issues
  • An ‘International Page’ that provides information about CECs abroad, international perspectives on clinical ethics, and details of courses and conferences held outside the UK.
  • Details of courses and conferences in the UK
  • Suggested reading to enable further research

Enquiries for further information about the Network have come from Norway, the Netherlands, Germany and North America. Several UK enquiries have been made requiring information and advice on setting up a clinical ethics committee.

Training for CECs

The Network Support Project provides support and information for those involved in establishing CECs. This includes presentations to trusts thinking of setting up a committee, or to a recently established committee. The Network website advertises courses that provide training relevant for CEC members. The Ethox team runs workshops that can be tailored to the requirements of an individual CEC.

Projects that involve the Network

Two projects concerned with Clinical Ethics Committees have been funded by a grant from the Department of Health to the Ethox Foundation. These projects are run in close collaboration with the UK Clinical Ethics Network.

1. Network Support Project

This project is to facilitate the development of a national network for clinical ethics committees in the UK. The project is funded from December 2002 for two years. It has spearheaded the ongoing development of the Network and has enabled the website and production of this Guide.

2. Education and Training Project

This project is to explore the education and training needs of members of clinical ethics committees (CECs) and to develop a range of teaching materials for them. The project runs from April 2003 to March 2005. As part of this project, pilot workshops were held on the following topics in 2004

  • Ethics and genetics
  • Ethics and the vulnerable patient
  • Ethics and resource allocation

Teaching materials will be prepared for members of CECs to pursue independently.

Contacting the Network

The Network can be contacted at:

Ethox Centre
Gibson Building
Block 21, Radcliffe Infirmary
Woodstock Road
Oxford OX2 6HA
Telephone: +44 (0) 1865 228793

Fax: +44 (0) 1865 2287884

Email: info@ukcen.net

Web site: www.ukcen.net

Reading

Slowther A, Johnston C, Goodall J and Hope T. Development of clinical ethics committees. BMJ 2004;328:950 - 952

Slowther A, Bunch C, Woolnough B, Hope T. Clinical Ethics Support in the UK: A review of the current position and likely development. 2001; The Nuffield Trust, London.

Blackburn, S. 2001. Ethics: a very short introduction. Oxford University Press

Copyright of Section B is held by The Ethox Centre.