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.
SIC: IT/IE