engleski

Historical development, current place and role, and need for a re-definiton of activities of ethics committees in croatian hospitals

Croatian experience in clinical ethics (more specifically in the process of making moral judgments in the clinical surrounding) is currently shaped only by ethics committees in medical schools or in hospitals. It is especially important to emphasize that review of scientific and clinical research protocols is identified as their main activity, neglecting other important functions, such as education, case analysis and consultations, and development of guidelines and institutional protocols. Besides the fact that team or individual ethics consultations are not developed in Croatia, such situation additionally burdens request for help in solving ethical dilemmas in everyday clinical practice. The reason my lay in the fact that Croatian ethics committees are of the so-called “mixed type” combining functions of research ethics committees (institutional review boards) and clinical ethics committees. Only in 2006, through the amendment of the Health Care Protection Act, the research-ethical activities were distinguished from clinical-ethical ones, and the existing “mixed type ethics committees” were divided in “hospital ethics committees” and “drug committees”, the later taking over the functions of institutional review boards. Unfortunately, still persistent legalist approach transforms potentially useful bodies in merely administrative ones, established for purpose of meeting legal demands. Within described medical-legal-institutional context, the authors will give the overview of decennial activity (from its establishment in 1997 until 2007) of the Ethics Committee of the University Hospital Rijeka, the second largest university hospital in Croatia, underlining the need for a broad re-definition of functions of hospital ethics committees in Croatia, and presenting first practical steps towards achieving this goal.

Croatia ; ethics, clinical ; ethics committees ; Health Care Protection Act ; University Hospital Rijeka

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