Monday, December 27, 2010

No overall policy on operation of ethics bodies in HSE hospitals

ETHICS COMMITTEES: THERE IS no overall Health Service Executive policy on the operation of ethics committees or forums in the hospitals under its control.

“Local arrangements are in place,” a HSE spokeswoman said yesterday. 

She said she was unable to establish what these were in relation to the various hospitals involved, but they were not necessarily the same as those operating in Cork University Hospital, where it emerged this week that an ethics forum decided a woman with terminal cancer could not have an abortion because her life was not under immediate threat.

The spokeswoman was unable to say how such ethics committees or forums were constituted or who decided who sat on them.

Research ethics committees are required under 2004 EU regulations, and are recognised by the Department of Health and Children. 

The committees set out the conditions under which clinical trials and other kinds of medical research can be carried out, and specify issues such as informed consent or assent. 

They have a statutory basis in EU law, as transposed into Irish law.

The results of the medical research carried out in research and teaching hospitals cannot be published unless it complies with the conditions laid down by such committees.

However, these committees do not have a statutory role in relation to clinical decisions in individual cases. 

The HSE spokeswoman was unable to say whether in certain instances they did consider these issues. 

However, she said most hospitals have ethics committees or ethics forums to assist medical staff in making ethically difficult decisions. 

They have no statutory basis and there appears to be little clarity or consistency about their role.

Ethics committees in hospitals run by Catholic religious congregations provide guidance in accordance with Catholic teaching. 

The mission statement for St Vincent’s University Hospital, for example, says it provides healthcare “through the continuance and furtherance of the ethos, aims and purposes of the Congregation of the Religious Sisters of Charity”.

Tallaght hospital has no ethics committee, said former director of the Adelaide Hospital Society, Dr Fergus O’Ferrall. 

The Adelaide was one of the hospitals which constituted Tallaght hospital. 

“This was a cardinal point in the move of the Adelaide to Tallaght,” he told The Irish Times . 

“We believed in the absolute confidentiality between the doctor and patient. There is no ethics committee that second guesses that in Tallaght.”

He said different ethical approaches to the treatment of pregnant women with cancer could arise, and this was a problem when cancer care was concentrated in hospitals where Catholic ethics prevailed. 

Tallaght was not designated a centre of excellence for cancer. 

“That issue was never addressed or made clear,” he said.