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Clinical Ethics Consultation in the Transition Countries of Central and Eastern Europe

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Abstract

Since 1989, clinical ethics consultation in form of hospital ethics committees (HECs) was established in most of the transition countries of Central and Eastern Europe. Up to now, the similarities and differences between HECs in Central and Eastern Europe and their counterparts in the U.S. and Western Europe have not been determined. Through search in literature databases, we have identified studies that document the implementation of clinical ethics consultation in Central and Eastern Europe. These studies have been analyzed under the following aspects: mode of establishment of HECs, character of consultation they provide, and their composition. The results show that HECs in the transition countries of Central and Eastern Europe differ from their western-European or U.S. counterparts with regard to these three aspects. HECs were established because of centrally imposed legal regulations. Little initiatives in this area were taken by medical professionals interested in resolving emerging ethical issues. HECs in the transition countries concentrate mostly on review of research protocols or resolution of administrative conflicts in healthcare institutions. Moreover, integration of non-professional third parties in the workings of HECs is often neglected. We argue that these differences can be attributed to the historical background and the role of medicine in these countries under the communist regime. Political and organizational structures of healthcare as well as education of healthcare staff during this period influenced current functioning of clinical ethics consultation in the transition countries.

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Notes

  1. For the following study, we define transition countries of Central and Eastern Europe as countries that after 1989 initiated a set of political, structural and social transformations from one-party, central rule towards democratic and pluralist political systems, with the aim of participation in the international and European institutions.

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  1. Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Parkstraße 11, 89073, Ulm, Germany

    Marcin Orzechowski, Maximilian Schochow & Florian Steger

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  1. Marcin Orzechowski
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Orzechowski, M., Schochow, M. & Steger, F. Clinical Ethics Consultation in the Transition Countries of Central and Eastern Europe. Sci Eng Ethics 26, 833–850 (2020). https://doi.org/10.1007/s11948-019-00141-z

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