2022 Volume 32 Issue 1 Pages 4-11
This paper aims to review the progression and current state of clinical ethics committees (hospital ethics committees) and consultations in Japan, to define the roles these institutions play in medical settings, and to examine challenges they face along with potential solutions. In the 1980s, medical schools began establishing ethics committees (institutional review boards) that has been designated to review and monitor biomedical research involving human subjects. By the 90s, these committees reviewed not only research protocols, but also ethical dilemmas faced in clinical settings. Eventually more specialized clinical ethics committees emerged which focused on providing clinical ethics consulting. Currently about a quarter of Japanese hospitals report voluntarily running clinical ethics committees and consultations, despite the fact no laws or official guidelines regulating them exist. Judgement guided by clinical ethical consulting should be considered to have legality. The main functions of clinical ethics committees and consultations are 1) providing ethical advice on specific cases, 2) developing guidelines for the hospital, and 3) providing information and training to medical personnel. Challenges include 1) record keeping, 2) information sharing, 3) promotion, and 4) sustainability. Potential solutions to aforementioned challenges are 1) creating minutes of meeting for committee, 2) share knowledge through academic conferences and professional organizations, 3) reaching out medical professionals in the community where ethical consulting is in demand, and 4) appointing dedicated staff in order to sustain the activities.
