Twenty years of the ethics committee at the medical faculty of the University of Vienna. An interim report

The organisation and assessment procedures of the ethics committee of the University of Vienna medical faculty are described. Data concerning the work of the committee from 1993 through to 1997 are given in detail. Finally, the results of a survey among physicians on the acceptance of the committee's work are presented. In conclusion, the workload of an ethics committee in a large medical faculty can only be handled by efficient management of assessment procedures. However, it is difficult to achieve sufficient acceptance in a field governed by various interests.

Ethics resources of US organ procurement organizations and transplant centers

The medical disciplines of organ and tissue donation and transplantation present many life-enriching benefits but are often fraught with ethical ramifications. This article examines the current and potential ethics resources of US organ procurement organizations (OPOs) and transplant centers (TCs). The organizations were surveyed regarding established ethical guidelines and the frequency with which ethical issues in need of resolution were encountered. All OPOs and 76% of TCs reported confronting ethical issues in the workplace. A majority of those surveyed in TCs and OPOs felt adequately prepared to face the ethical challenges of their jobs. More than half the surveyed personnel had some type of ethics training, but only 25% of the TC staffs and 16% of the OPO staffs' training was during the survey year. The potential for ethics-related interactions for TC and OPO staff must be recognized and adequate preparatory measures provided.

Ethical review of a multicentre study in Scotland: a weighty problem

OBJECTIVE

To assess the current working practices of local research ethics committees (LRECs) in their review of a multicentre study approved by the new multicentre research ethics committee in Scotland.

DESIGN

Observational data collected from correspondence with LRECs.

SUBJECTS

All LRECs within the geographical area of the study in Scotland.

INTERVENTIONS

None.

OUTCOME MEASURES

Delay from application to calling an LREC meeting, to an initial LREC decision, to final LREC approval, and the number of A4 pages required.

RESULTS

The median delay to review of an application at an LREC meeting was 28 days (range 14-97), the median delay from application to the time of LREC final approval was 39 days (range 21-109) and a total of 5,789 A4 pages (26.9 kg) were required to complete the application process.

CONCLUSIONS

Despite recent standardisation of ethical review of multicentre research, elimination of unnecessary delay, cost and variation in LREC operating procedures is still necessary.

Role of the research ethics committee

Research ethics committees have an important role to play in ensuring the ethical standards and scientific merit of research involving human subjects. There are three important obligations placed on the ethics committee. Firstly, and most importantly, the ethics committee must ensure that the rights of research participants are protected. This is achieved by ensuring that individuals receive sufficient information, which can be easily understood, and ensuring that appropriate strategies are in place to protect participants from potential adverse consequences of the research. Secondly, the research ethics committee has an obligation to society which provides the resources for research and will ultimately be affected by the results. Thirdly, the research ethics committee has an obligation to the researcher. The research proposal should be treated with respect and consideration. The research ethics committee should strive to meet each of these obligations. All researchers should welcome the contribution made by research ethics committees to the research process because they help to ensure that research meets the high ethical and scientific standards expected by society.

An acute-care model in the management of end-of-life issues

Healthcare professionals who provide direct patient care have the knowledge and skill to discuss the biophysiologic aspects of a patient's condition, but the discussion of the management of end-of-life and bioethical issues is often problematic. In this article, we discuss practices and procedures that have proved helpful in encouraging open discussion of end-of-life issues, as well as appropriate management.