Hva kan vi lære av erfaringer med å delta i etikkdrøftinger? En kvalitativ studie fra etikkomiteer i norsk kommunehelsetjeneste

Abstract

Introduction: Ethical challenges arise daily in the municipal health service. These challenges can be addressed systematically, and ethics committees can play a vital role to facilitate such discussions. The purpose of this study is to explore the experiences of individuals participating in ethical discussions and identify key factors that influence the establishment and operation of these committees. Method: This study adopts a qualitative approach, involving 22 in-depth interviews with healthcare personnel (stakeholders), six interviews with next-of-kin, and three focus group interviews with resource persons. A reflexive thematic content analysis is used. Results: Ethics discussions involved minimum stakeholders and committee members, with occasional inclusion of next-of-kin. No patients participated. Participants found ethics committees valuable, both at systemic and individual levels. Ethical discussions provided support and security in complex decision-making processes, though the ethics language could be unfamiliar and challenging to understand. The establishment and operation of ethics committees required significant effort. This placed substantial responsibility on resource persons. Discussion: Ethics committees offers help facilitate reflecting on crucial values, and can contribute to a broad discussions on challenging ethical issues. The participants experienced this valuable, while use of the specialized ethical language can be alienating. However, this language can also help structure and understand complex questions and emotions. Ethics discussions can promote better communication, when those who are affected are involved. Competence and resources are crucial, and municipal leadership has a key role to succeed.