Review of Everyday Ethics: Clinical Ethics & Theory in Practice , University of Bristol

Review of “Everyday Ethics: Clinical Ethics & Theory in Practice”, University of Bristol.

This year’s annual Bioethics student-led conference at the University of Bristol aimed to demonstrate the importance of clinical ethics committees, and illustrate the application of theoretical ethics to every day clinical situations. Over fifty delegates attended with a wide spread of involvement in clinical practice, medical ethics and law. This included staff and students from the School of Social and Community Medicine and the Faculty of Medicine and Dentistry from the University of Bristol (UoB), as well as nursing staff and students from the University of West England.

Morning session

Bioethics students and organisers, Chloë de Souza and Lauran Noel, began by introducing the day and speakers. Dr Carwyn Hooper, Lecturer in Medical Ethics and Law at St Georges, University of London, started the series of talks by discussingthe implications that future technology might have on the more traditional notions of confidentiality. From social media to national medical record databases, he highlighted areas in which health care professionals commonly violate the principle of confidentiality unintentionally, and how this problem may develop in the future.

Secondly, Wellcome Trust biomedical ethics research fellow and paediatric intensive care nurse, Giles Birchley, talked about the conflict between acting in the patient’s best clinical interests and the importance of joint decision-making between parents and doctors. This conflict is especially relevantwith regard to the withdrawal of treatment in end of life care if health care professionals and parents disagree. Giles eloquently discussed the conflicting ethical criteria concerned, as well as the current unclear legal standards.

Dr Carolyn Johnston,Advisor in Medical Law and Ethics at Kings College London, presented a talk about the difficulties associated with adolescent autonomy and the practical and theoretical disparities between refusal of treatment and non-compliance. Non-compliance is a particularly prevalent issue amongst young adults and Carolyn discussed whether incentives to encourage engagement are ethically permissible.

Ruud ter Meulen, Professor of Ethics and Medicine at the UoB, delivered the final talk of the morning. Ruud discussed whether age is an ethically permissible criterion for distribution of health care resources. He identified the problems associated with the social status of elderly people and the disengagement they feel from society; the medicalization of old age, and the decline in traditional forms of solidarity between the elderly and younger populations.

Afternoon Session

The afternoon session began with our Key Note Address delivered by Dr Anne-Marie Slowther, the Associate Professor of Clinical Ethics at the University of Warwick, and Chair of the Board of Trustees of the UK Clinical Ethics Network. Anne gave a very insightful talk on the role of clinical ethics committees, why they exist and how they work. She discussed the manner in which the UK Clinical Ethics Network has grown over the past few years, and how this has enabled open disclosure and discussion of complicated cases in order to educate committee members. She then went on to emphasise why it is important to generate increased awareness about clinical ethics committees among health care professionals, so that referral of ethically loaded cases becomes an established practice. Furthermore, Anne demonstrated the methodical fashion in which committees are encouraged to approach cases, which provided delegates with a structure to help facilitate the afternoon discussions.

Delegates were divided into four groups. Each group was chaired byUoB bioethics students, and was assigned one of the four cases outlined in the morning session.Using the advice given by Dr Slowther, the groups discussed the ethical implications of all potential outcomes of their cases, in order to come to a conclusion that would be both realistic and ethically desirable.

Following this, the groups came back together for a panel-led discussion. Members of the panel included the day’s speakers in addition to Dr Richard Huxtable, the Deputy Director of the Centre for Ethics in Medicine. Dr Wouter Kalf, an ethics and philosophy teaching fellow at the UoB chaired the session. In turn, a nominated speaker from each group of delegates presented their recommendation along with a brief justification for their reasoning. The panel deliberated these recommendations, before allowing the floor to ask any further questions. The speaker who originally proposed the case was then given the opportunity to state what was the actual outcome was, and why.

The day was thoroughly enjoyed by all and our sincere thanks go to our sponsors - the Institute of Medical Ethics, Galenicals (UoB Medic Society) and Wesleyan. We look forward to the conference next year.