CLINICAL ETHICS COMMITTEES IN ONCOLOGICAL CARE: ASSESSING IMPACT AND EXPLORING STAKEHOLDERS¿ PREFERENCES ON CLINICAL ETHICS SUPPORT SERVICES

Clinical Ethics Committees (CECs) were developed to support healthcare professionals in the management and resolution of ethical issues in clinical practice. The presence of a clinical ethics support service in healthcare facilities is becoming an ever-increasing standard in dealing with the ethical dimension of clinical issues. CECs, and clinical ethics support in general, are in fact conceived as a tool to guarantee humanization and personalization of care, by balancing of the rights of those involved and the ethical principles at stake, aiming at a constant improvement of the care pathway. In Italy, CECs begun to arise only recently, and it is urgent to understand how CECs can fit into the national context. Based on these premises, this project aims to explore the role and effectiveness of CECs and to propose the ideal features that an ethics support service should have in order to meet the current needs of a concrete clinical context. In order to achieve this twofold goal, first we investigated the role and impact that CECs have in the institutions where they carry out their activities, with the aim of understanding their strengths and potential criticalities. Secondly, we conducted a qualitative study at the Fondazione IRCCS Istituto Tumori, to explore the Institute's healthcare personnel and stakeholders’ experiences with ethical issues and their expectations towards ethics support. Whereas assessing CECs’ performance has proved highly problematic, their impact in clinical practice seems to be overall positive. Ethics support, along with the standard activities of a CEC seem desirable to stakeholders, most of whom have no training in bioethics but recognize the need for ethical reflection at least as they aim at promoting an ethical reflection on care processes and would welcome support in managing the ethical aspects of complex clinical issues.