Abstract
According to UNESCO guidelines, one of the four forms of bioethics committees in medicine are the Hospital Ethics Committees (HECs). The purpose of this study was to evaluate how the above guidelines are implemented in real practice. There were 111 hospitals selected out of 176 Polish clinical hospitals and hospitals accredited by Center of Monitoring Quality in Health System. The study was conducted by the survey method. There were 56 (50 %) hospitals that responded to the survey. The number of HECs members fluctuated between 3 and 16 members, where usually 5 (22 % of HECs) members were part of the board committee. The composition of the HECs for professions other than physicians was diverse and non-standardized (nurses—in 86 % of HECs, clergy—42 %, lawyers—38 %, psychologists—28 %, hospital management—23 %, rehab staff—7 %, patient representatives—3 %, ethicists—2 %). Only 55 % of HECs had a professional set of standards. 98 % of HECs had specific tasks. 62 % of HECs were asked for their expertise, and 55 % prepared <6.88 % of the opinions were related to interpersonal relations between hospital personnel, patients and their families with emphasis on the interactions between superiors and their inferiors or hospital staff and patients and their families. Only 12 % of the opinions were reported by the respondents as related to ethical dilemmas. In conclusion, few Polish hospitals have HECs, and the structure, services and workload are not always adequate. To ensure a reliable operation of HECs requires the development of relevant legislation, standard operating procedures and well trained members.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Act of 5 December 1996 on professions of physician and dentist. (1997). Journal of Laws, 28, pos.152 (unified version). http://isap.sejm.gov.pl/DetailsServlet?id=WDU19970280152. Accessed 20 Mar 2014.
Act of 6 November 2008 on accreditation in healthcare. (2009). Journal of Laws, 52, pos.418 (unified version). http://isap.sejm.gov.pl/DetailsServlet?id=WDU20090520418. Accessed 20 Mar 2014.
Act of 6 November 2008 on patient’s rights and the Commissioner of Patients’ Rights. (2009). Journal of Laws, 52, pos.417 (unified version). http://isap.sejm.gov.pl/DetailsServlet?id=WDU20090520417. Accessed 20 Mar 2014.
American Academy of Pediatrics. (2001). Institutional Ethics Committees. Committee on Bioethics. Pediatrics, 107(1), 205–209.
Aulisio, M. P., & Arnold, R. M. (2008). Role of the ethics committee: Helping to address value conflicts or uncertainties. Chest, 134(2), 417–424.
Aulisio, M. P., Arnold, R. M., & Youngner, S. J. (2000). Health care ethics consultation: nature, goals and competencies. Annals of Internal Medicine, 133(1), 59–69.
Campbell, A. V. (2001). Clinical governance—watchword or buzzword? Journal of Medical Ethics, 27(Suppl 1), 854–856.
Center for Health Care Quality Monitoring. (2009). Standards for Accreditation. Kraków. http://przetargi.cmj.org.pl/zestaw_standardow_akredytacyjnych.pdf. Accessed 20 Mar 2014.
Central Statistical Office. (2012). Statistical yearbook of the Republic of Poland. Warsaw: Central Statistical Office.
Central Statistical Office. (2013). Statistical Yearbook of the Republic of Poland, http://www.stat.gov.pl/cps/rde/xbcr/gus/RS_rocznik_statystyczny_rp_2013.pdf. Accessed 20 Mar 2014.
Conference of Presidents of Medical Societies. (2009). Conference of Presidents of Medical Societes of 14 December 2009 on Hospital Ethics Committees. http://www.nil.org.pl/__data/assets/pdf_file/0014/7430/stanowisko_KPTL_w_sprawie_szpitalnych_komisji_etycznych.pdf. Accessed 20 Mar 2014.
Czarkowski, M. (2010a). Are the hospital ethics committees necessary in Poland? Anestezjologia i Intensywna Terapia, 42(1), 47–50.
Czarkowski, M. (2010b). How can we establish hospital ethics committees? Polski Merkuriusz Lekarski, 28(165), 207–210.
Czarkowski, M. (2011). Omnnis mutatio periculosa? About Hospital Ethics Committees. In J. Hartman & M. Waligóra (Eds.), Ethical aspects of medical decisions (pp. 134–135). Warszawa: Wolters Kluwer Polska.
Florida Bioethics Network. (2011). Guidelines for ethics committees. Miami: Florida Bioethics Network.
Førde, R., & Pedersen, R. (2011). Clinical ethics committees in Norway: What do they do, and does it make a difference? Cambridge Quarterly of Healthcare Ethics, 20(3), 389–395.
Fox, E., Myers, S., & Pearlman, R. A. (2007). Ethics consultation in United States hospitals: A national survey. American Journal of Bioethics, 7(2), 13–25.
Gaudine, A., Thorne, L., LeFort, S. M., & Lamb, M. (2010). Evolution of hospital clinical ethics committees in Canada. Journal of Medical Ethics, 36(3), 132–137.
La Puma, J., Orentlicher, D., & Moss, R. J. (1991). Advance directives on admission clinical implications and analysis of the patient self-determination Act of 1990. Journal of American Medical Association, 3, 402–405.
Orr, R. D., & Shelton, W. (2009). A process and format for clinical ethics consultation. Journal of Clinical Ethics, 20(1), 79–89.
Pedersen, R., Akre, V., & Førde, R. (2008). Barriers and challenges in clinical ethics consultations: the experiences of nine clinical ethics committees. Bioethics, 23(8), 460–469.
Polish Bioethics Society. (2009) Polish Bioethics Society Declaration on Clinical Ethics Committees of 26 September 2009. http://www.ptb.org.pl/oswiadczenia_en.html. Accessed 20 Mar 2014.
Pontifical Council for Pastoral Assistance to Health Care Workers. (1995). The charter for health care workers. www.ewtn.com/library/curia/pcpaheal.htm.
Regulation of the Minister of Health of 31 August 2009 on procedure used to assess the execution of accreditation standarts by hospitals (2009) Journal of Laws, No. 150, pos. 1216.
Rosner, F. (1985). Hospital medical ethics committees: A review of their development. Journal of American Medical Association, 253(18), 2693–2697.
Sagan, A., Panteli, D., Borkowski, W., Dmowski, M., Domański, F., Czyżewski, M., et al. (2011). Poland: Health system review. Health Systems in Transition, 13(8), 1–193.
Schick, I. C., & Moore, S. (1998). Ethics committees identify four key factors for success. HEC Forum, 10(1), 75–85.
Slowther, A., Bunch, C., Woolnough, B., & Hope, T. (2001). Clinical ethics support services in the UK: An investigation of the current provision of ethics support to health professionals in the UK. Journal of Medical Ethics, 27(Suppl 1), i2–i8.
Slowther, A., Johnston, C., Goodall, J., & Hope, T. (2004a). A practical guide for clinical ethics support. Oxford: Ethox.
Slowther, A., Johnston, C., Goodall, J., & Hope, T. (2004b). Development of clinical ethics committees. British Medical Journal, 328, 950–952.
Slowther, A. M., McClimans, L., & Price, C. (2012). Development of clinical ethics services in the UK: A national survey. Journal of Medical Ethics, 38(4), 210–214.
Supreme Medical Council. (2009). Stance No 14/09/V of the Supreme Medical Council of 6 February 2009 on Hospital Ethics Committees. Bulletin of the Supreme Medical Council, 7, 1. http://www.oil.org.pl/res/img/img/nil/gazeta/biuletyn/r2009/7_2009.pdf. Accessed 20 Mar 2014.
UNESCO. (2006). Universal declaration on bioethics and human rights. Paris: UNESCO.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Czarkowski, M., Kaczmarczyk, K. & Szymańska, B. Hospital Ethics Committees in Poland. Sci Eng Ethics 21, 1525–1535 (2015). https://doi.org/10.1007/s11948-014-9609-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11948-014-9609-x