About the Clinical Ethics Service

Many of our daily activities involve making ethical decisions however big or small.Ethics refers to the rules and principles which distinguish between right and wrong and although these principles do not always dictate a single moral course of action they can provide a means of evaluating and deciding among competing options.

Needless to say ethical dilemmas are common in professional life at a place like Great Ormond Street Hospital (GOSH) so a Clinical Ethics Service has been developed to ensure that you feel supported and prepared to make these decisions.

Concerns about the frequency with which ethical dilemmas arise and the lack of an organised structure to provide analysis, support and training for those involved led to the establishment of a Working Party in 1995 to consider how these needs might be met.

Following a formal questionaire consultation, one of the UK's first Clinical Ethics Fora was established. This eventually became the Clinical Ethics Committee in 2000. A further staff survey indicated the need for a more responsive service.

The Trust responded by founding the first consultant post in clinical ethics in 2005 with funding from the Special Trustees.

The clinical ethics service aims to create a culture within GOSH in which the ethical issues that staff, patients and their families face can be discussed openly.

These groups are increasingly faced with ethical dilemmas regarding treatment decisions or those associated with withdrawing invasive or life sustaining care.

Often we find that conflict can arise from the religious beliefs of families (whatever faith they may follow), the technological advances posed by modern medicine, or from the social stigma associated with some illnesses and treatments.

Recently some such cases have been the focus for media attention, court decisions and even a recent TV series.

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The Clinical Ethics Service can help to navigate this increasingly complex area by providing a service that supports staff, parents and patients in dealing with the ethical aspects of the decisions.

The Clinical Ethical Service includes the Clinical Ethics Committee and a consultation service, where ethical issues can be openly discussed either as part of the monthly meeting of the committee or by a representative panel of members which, if required, can meet at short notice. Teaching sessions and advice are also available.

The Clinical Ethics Service will build on the already strong ethical foundations at GOSH and offer a platform from which the profile of paediatric ethical issues can be raised.  By providing a forum which generates and facilitates learned and informed debate into ethical issues concerning children we can promote open dialogue and analysis of the ethical issues which affect the treatment of children.

The important thing to remember is that ‘there are no right answers in ethics’. The GOSH Clinical Ethics Service is here to provide support and advice. By working together to apply the appropriate ethical principles with dignity, respect, openness and transparency it may help those who seek its opinion towards the most ethical course of action and becomes part of the holistic care of the children here at GOSH.