Paul McConnell, Chair SSC 16
With the ongoing advance of both clinical and experimental medicine, the ethics subcommittee has positioned itself to provide up-to-date guidance and education for clinicians who must grapple with the difficult questions of the age.
An ongoing series of editorial pieces have been featured in the EJA addressing topics such as futility and treatment-limiting decisions, organ donation, and ethical difficulties in obstetric practice.
A large audit of all the submissions to the 2015 annual congress has also been completed in conjunction with the ICM subcommittee, looking at whether appropriate ethical approval had been granted to studies prior to submission. The results of this will be featured in an upcoming issue of the EJA and, based on what has been found, the abstract submission system for the annual congress is undergoing revision in preparation for 2018, with a commitment from the ESA to ensure that the society adheres to the best ethical practice in its publications and abstracts. There will also be work done to improve knowledge around the role of Research Ethics Committees and their importance.
The 2017 annual congress in Geneva enjoyed a full ethics programme that saw sessions examining palliation and end-of-life care with a Pro/Con debate on assisted suicide as part of end-of-life practice. Errors, candour, and improving services featured in a symposium on ‘when things go wrong’, which also addressed duty of care and medical negligence, while the ethical challenges of resuscitation were addressed in a symposium that looked at patient-centred decision making in resuscitation, harm from inappropriate resuscitation, and ‘death denial’ in the ICU. The congress also saw a lighter hearted, but equally important look at what can happen when you answer the call ‘Is there a doctor on this plane?’ along with an overview of European Laws surrounding ‘Good Samaritan’ acts. Geneva also saw the first pre-congress course in ethics, which took the form of small group workshops. It provided an overview of ethical thought in clinical practice before focusing on difficult issues in consent and end-of-life care.
Future work will look at conscientious objection in medicine and the treatment of Jehovah’s Witnesses in the perioperative period, with upcoming pieces in ESA Newsletter, as well as a study looking at treatment-limiting decisions and withdrawal of support in ECMO patients.
Looking ahead to Copenhagen, we will have a Pro/Con debate on conscientious objection in medicine, and symposia examining religion and spirituality in medicine and their impact on clinical care, dementia in the perioperative period, and how to address the ethical difficulties in consent and best interests, factors which influence ICU outcomes and address the question ‘Am I more than my genes?’ and address the issues surrounding medicine and migration. We will also be hosting a second pre-course course in ethics. Building on the success of our Geneva workshop, we will take a small group approach led by experts examining ethical leadership, end-of-life care, and, new for this year, conflict resolution between colleagues and relatives.
Science and medicine are ever evolving, and the Scientific Ethics Committee will be there at every step to provide knowledge, expertise, and guidance. If you have an interest in ethics contact the committee or come to our open committee meeting at the congress in Copenhagen.