What is the Healthcare Ethics Committee
The Healthcare Ethics Committee (CEA) is an advisory body of the Corporació Sanitària Parc Taulí (CSUPT) that aims to collaborate in improving the quality of care in its ethical aspect, because quality has not only a technical dimension but also moral
The documents prepared by the CEA are basically aimed at professionals, but some, such as the guide to promote the implementation of advance directives or informed consent documents, want to encourage patient participation in their own health decisions.
The functions of the CEA are:
Propose guidelines for professional action in the face of ethical conflicts
Advise on ethical healthcare issues
Promote training activities in this field
Operation and activities
Internal and monthly work sessions
Extraordinary meetings when there are issues or queries that require it
Attendance and / or participation in events related to Bioethics
Organization of events and training sessions in this area
The Parc Taulí Healthcare Ethics Committee
In 1989, at the request of the management and the medical directorate and as a result of a specific problem, the need arose to consider the ethical aspects in the care of CSPT patients. In 1990, the Conceptual Framework was approved, a document that establishes the bases for the model of Institution to be developed. Both the Conceptual Framework and the Master Plan for the years 1990-1991 show the need to address the ethical conflicts that arise in the daily care practice.
The Management and the Medical Direction of that moment, promote the creation of a Committee of Healthcare Ethics (CEA). It facilitates the training of a person in Bioethics i. Once the basic training has been provided, a "Promotional Commission for the Creation of a CEA" (1991) is set up, made up of professionals (doctors, nurses, social workers and non-care staff) who expressed interest in the subject and their commitment. to carry out the task.
The Commission begins to work on the training in Bioethics of the members, at the same time as it is made known in the different areas of the Institution, in order to raise awareness and inform other professionals.
June 1993 marks two years since the commission of the promoter was set up and the CEA was set up, appointed by the Governing Council of the Consortium in accordance with the internal regulations drawn up by the Commission. As of this moment, the CEA already has a fully regulated structure with the appointment of a president and secretary and the incorporation of other professionals: a legal adviser, a representative of the Quality Committee, a member of the Management and a member. outside the institution.
Accreditation is also obtained according to the “Order of 14 December 1993 accrediting the Healthcare Ethics Committees” published in the DOGC, being one of the first Committees accredited and approved by the Health Resources Directorate of the Generalitat de Catalunya.
In accordance with the Order of Accreditation of the Healthcare Ethics Committees of the Generalitat de Catalunya, the CEA of Parc Taulí is made up of: doctors, nursing staff, staff with non-direct care tasks and a person outside the institution
How to contact them
Tools and resources
The guidelines prepared by the CEA are aimed at doctors / healthcare staff. They can be helpful in helping the general public understand their doctor’s performance in circumstances in which both the patient and family may be especially vulnerable.
Guide on the adequacy of the therapeutic effort at the end of life. (2015)
Healthcare currently raises more and more problems about the more appropriate use of new knowledge, which are not only related to the medical side, but also, and very intensely, to the legal world and the complex. world of ethical values.
The concept of adequacy of therapeutic attitude potentially affects all patients, but especially those with chronic and debilitating illnesses, physical and mental, with acute illnesses, or exacerbations of chronic, which can be life-threatening.
This work aims to reflect on attitudes around end-of-life care to improve patients ’overall health care. The guide emphasizes the decision making process but it also includes reflections on artificial nutrition or medically assisted, pediatric patient and Non-Resuscitation Orders (ONR).
Guide to rejection (start or withdrawal) of treatment. Includes regulations for the use of voluntary discharge. (2015)
The aim of the guide is to guide professionals when the patient rejects the indicated treatment alternative, and especially in that more particular situation of rejection of blood that occurs among Jehovah's Witnesses.
The situation of rejection of a therapeutic alternative is an important source of tension for patients and professionals. This tension is even more important in the case of blood transfusion because of the consequences it can have and the characteristics that surround it. The guide aims to reduce this tension and make decisions more comfortable, avoiding the variability of practice and decision-making without prior reflection. It also aims to avoid undesirable consequences (cancellation of an intervention, stress in an emergency situation for not knowing what to do, etc.), encourage respect for current legislation and, above all, promote patient autonomy.
After an ethical and legal reflection, the guide includes some general action recommendations, an analysis of the rejection of transfusions and the considerations of using voluntary discharge, which should only be used when the patient (or its representatives if it is incapacitated) rejects all treatment alternatives.
Guide to the care of confidentiality in the CSPT. (2015)
This document responds to the objective of giving practical guidelines for the care of confidentiality, which respect legal regulations, take into account ethical regulations and express a commitment to excellence.
After a brief introduction on the concept of confidentiality, related aspects and legal and deontological regulation, it addresses five areas on which it makes various practical recommendations. These areas are:
1- Confidentiality and care activity: Criteria are provided, among others, regarding the access of relatives to information and exceptions to the duty of confidentiality.
2. The confidentiality and the clinical documentation where the access by different instances appears (Administration, Insurance companies, etc ..) to the patient's documentation.
3. Confidentiality and information systems.
4. The confidentiality of professional data: difference between health data, identifying data and data derived from professional activity. It proposes criteria of accessibility and safeguard of this one.
5. Confidentiality and the media. The access of the media, and the internal circuit, to the different data (identifying, diagnoses, etc.) are specified.
Guidelines for assessing patients' ability to make decisions. (2015)
Capacity is one of the essential conditions for exercising autonomy in health decision-making, and therefore it must be respected and promoted.
The capacity of the person is one of the requirements of the informed consent process along with information, voluntariness and authenticity. There is, however, no consensus on criteria, standards and protocols for assessing capacity, a situation that can lead to uncertainty in clinical practice.
This guide has been developed in order to guide professionals when faced with situations that require a formal assessment of the patient's ability to decide on a particular medical intervention.
It includes institutional rules to improve care in this specific area as well as a form to facilitate the assessment of patient capacity.
Guide to the informed consent document for daily care practice. (2013)
Informed consent (IC) is considered to be the paradigm of the care relationship between health professionals and the patient, given that their active participation in decisions that affect them is an indispensable requirement to ensure an ethical relationship and also legal, since the written IC is regulated by law, both within the state and in Catalonia.
This guide aims to provide professionals with the necessary tools to implement a new CI sheet and at the same time standardize all the Corporation's CIs with regard to the development and elaboration of these sheets.
It proposes an IC with a generic content, adaptable to any situation, accompanied by an information sheet of the related procedure and a method of elaboration of both documents that contemplates the indispensable content that they must have.
Guide to Deciding on Physical Constraint (2007) (Under Review)
By physical restriction we mean the use of physical or mechanical procedures aimed at limiting the movements of part or all of the body in order to limit the patient's physical activities, to protect him from injuries that could be infringed on himself or herself. other people.
The use of physical restraint measures can injure the patient's autonomy, which is why their use must be carefully justified.
This guide to the application of restrictive measures has been made with the intention of helping professionals make the decision of when and how to apply them in order to ensure a real benefit for the patient, proposing alternatives and methodology. to follow so that its establishment is as correct as possible.
Guidelines on the use of Advance Will Documents (DVA) in the Parc Taulí Health Corporation. (2001)
This document, which is based on the “Considerations on DVA” and the “Orientation Model” carried out by the Bioethics Committee of Catalonia, aims to serve as a guide for the knowledge and use of DVA in the CSPT.
A DVA is the collection of a series of instructions expressed by the signatory of the document, so that they are taken into account if he reaches a situation in which he cannot express his will. It is what is known as a living will. It also provides for the appointment of a representative, an important figure in defending compliance with these instructions and helping to make decisions.
The guide sets out the basis and purpose of these documents, what the legal support is, and what a DVA consists of.
It also explains the possible content and the issues and requirements to be taken into account when making and formalizing the document.
Attach a model of what a DVA might look like.
Documents of interest
Spanish and Catalan legislation
Charter of Citizens' Rights and Duties in Relation to Health and Health Care (2001)
LAW 21/2000, of December 29, on the rights of information concerning the health and autonomy of the patient, and the clinical documentation. DOGC no. 3303 - 11/01/2001.
LAW 41/2002, of November 14, basic regulation of patient autonomy and rights and obligations in matters of information and clinical documentation.
Links related to bioethics
Bioethics Committee of Catalonia ( http://comitebioetica.cat/ )
Bioethics and Law Observatory ( http://www.pcb.ub.edu/homepcb/live/es/p693.asp )
Víctor Grifols Foundation ( http://www.fundaciogrifols.org )
Borja Institute of Bioethics ( http://www.ibbioetica.org )
From the rest of Spain
Spanish Bioethics Committee ( http://www.comitedebioetica.es/ )
International Society of Bioethics. (http://www.sibi.org/)
AEBI. Association of Bioethics and Medical Ethics. ( www.aebioetica.org)
From the rest of Europe
Council of Europe. ( http://www.coe.int/t/dg3/healthbioethic/ )
Center for Research Ethics & Bioethics (CRB) Uppsala University ( http://www.crb.uu.se/ )
BMC Medical Ethics ( http://www.biomedcentral.com/bmcmedethics/ )
From North America
The Hastings Center ( http://www.thehastingscenter.org/ )
Joint Center for Bioethics. University of Toronto ( http://www.jointcentreforbioethics.ca/index.shtml )
WMA. World Medical Association ( http://www.wma.net/en/10home/index.html )