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Part of the fabric and mostly right: an ethnography of ethics in clinical practice

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Would clinical ethics support services be useful in Australian hospitals?

Clinical ethics support is an emerging field of theory and practice concerned with enhancing the ethical quality or “ethicality” of clinical practice (rather than research) in hospitals and other health care institutions.1,2 Clinical ethics support is typically delivered by a multidisciplinary ethics committee, an individual ethicist, or both. Its aim is to provide informed advice for the development of organisational policies, as part of staff education, and in ethically difficult situations that arise in the institution.

Clinical ethics support services are an established feature of health care in the United States and Canada, and are becoming more common in the United Kingdom and elsewhere in Europe and Asia. Although such programs have not been systematically evaluated, observational and experimental studies indicate that clinicians find them helpful, and that they reduce conflict, save money and improve the overall quality of patient care.38While there has been grassroots enthusiasm for the development of clinical ethics support services in Australia (they are already available in some hospitals9