Clinical Ethics Committees: an analysis of their role and function

Healthcare Clinical Ethics Committees (CECs) are increasing in numbers. Critics argue that they undermine the moral development of the practitioner by not encouraging them to think deeply and for themselves about medical ethics. This could result in abrogation of responsibility for decisions to CECs.\ud \ud This thesis will argue that CECs can offer a useful service to clinicians in the UK by providing a safe environment for reflection. Within this space the CEC can support exploration of solutions to the issues by using a non directive structure to their questioning techniques. Central to this process is the need for the clinician to be present throughout the discussion. Within this reflective space, questioning by the CEC is structured to enable practical planning to occur, after dialogue about the situation or issue, acknowledging the impact of emotion, and moral and nonmoral influences influencing the case. This thesis proposes the use of solution focused techniques and casuistry within the CEC which form the basis of a model developed by the author entitled the ASCS (Ask, Seek, Clarify and Solution)\ud model. Use of the model can provide a framework for structured dialogue which is simple, evaluable and brief. Use of the model within the UK CEC has the potential to increase the skills of the practitioner to tackle ethical issues in practice. Such skills once learnt can be utilised by the team to deal with ethical conflict in the workplace in the future