Etikkdrøftinger i kommunale etikkomiteer – hva bidrar det til?

Abstract

Introduction:In the municipal health service, demanding ethical challenges arise on a daily basis. It is advantageous to discuss these systematically. One measure that can be implemented to ensure that discussions are systematic is to establish ethics committees.Through a research project, four Norwegian municipalities received implementation support to establish ethics committees. The participating municipalities organized this work as local professional development projects and appointed two resource persons who were given central coordination and leadership roles. The same people also took roles as a leader and secretary of the ethics committees. The aim of the PhD project was to gain more knowledge about involved parties' experiences of participating in ethics discussions, and to study which key factors can influence establishment and operation of this ethics committees. Method:The research project has a qualitative design. 22 in-depth interviews have been conducted with healthcare personnel who approached the ethics committees with cases ("stakeholders"), six in-depth interviews with next-of-kin and three focus group interviews with resource persons in three different phases of the research project. In addition, five dialogue seminars were arranged with resource persons and researchers during the research period. The study also has an element of action research. The data material has been analyzed using a reflexive thematic content analysis.Result: Establishing municipal ethics committees is considered as useful, at both system and individual level. However, the establishment entailed a considerable amount of work and a great deal of responsibility for those who took on the role of resource person. At least two parties participated in the ethics discussions: Stakeholders, who were healthcare personnel, and ethics committee members. In some instances, next-of-kin also took part in ethics discussions, but no patients. Stakeholders and next-of-kin experienced that participating in ethics discussions gave them a great degree of support and security in demanding decisionmaking processes. The participants in the study learned that ethics discussions in the ethics committee gave increased competence, and that reflection on ethical issues contributed to better communication and interaction between those affected by the case. However, both stakeholders and next-of-kin missed good and tailored information before the meeting, what participation in an ethics committee discussion was, the purpose of the ethics discussion and