Clinical Ethics > Volume 4, Number 3 > Pp. 131-138

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Empirical Ethics

Clinical ethics consultation in Europe: a comparative and ethical review of the role of patients

Véronique Fournier ^* , Eirini Rari ^*, Reidun Førde , Gerald Neitzke , Renzo Pegoraro  and Ainsley J Newson ^**

^* Centre d'éthique clinique, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, 27 rue du faubourg Saint Jacques 75014 Paris, France Section for Medical Ethics, University of Oslo, Olso, Norway Institute for History, Ethics and Philosophy of Medicine, Hannover Medical University, Hannover, Germany Fondatione Lanza, Padova, Italy ^** Centre for Ethics in Medicine, Department of Community Based Medicine, University of Bristol, Bristol, UK

E-mail: veronique.fournier{at}cch.aphp.fr

Clinical ethics has developed significantly in Europe over the past 15 years and remains an evolving process. While sharing our experiences in different European settings, we were surprised to discover marked differences in our practice, especially regarding the position and role of patients. In this paper, we describe these differences, such as patient access to and participation or representation in ethics consults. We propose reasons to explain these differences, hypothesizing that they relate to the historic and sociocultural context of implementation of clinical ethics consultation services (Cecs), as well as the initial aims for which each structure was established. Then, we analyse those differences with common ethical arguments arising in patient involvement. We conclude that there is no unique model of best practice for patient involvement in clinical ethics, as far as Cecs reflect on how to deal with the challenging ethical issues raised by patient role and position.

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