The aim of this study was to assess nurses’ and physicians’ ethical dilemmas in clinical practice. Nurses and physicians of the Clinical Hospital Centre Rijeka were surveyed (N = 364). A questionnaire was used to identify recent ethical dilemma, primary ethical issue in the situation, satisfaction with the resolution, perceived usefulness of help, and usage of clinical ethics consultations in practice. Recent ethical dilemmas include professional conduct for nurses (8%), and near-the-end-of-life decisions for physicians (27%). The main ethical issue is (...) limiting life-sustaining therapy (nurses 15%, physicians 24%) and euthanasia and physician-assisted suicide (nurses 16%, physicians 9%). The types of help available are similar for nurses and physicians: obtaining complete information about the patient (37% vs. 50%) and clarifying ethical issues (31% vs. 39%). Nurses and physicians experience similar ethical dilemmas in clinical practice. The usage of clinical ethics consultations is low. It is recommended that the individual and team consultations should be introduced in Croatian clinical ethics consultations services. (shrink)

This paper attempts to draw on management theory and practice and, more specifically, on know-how from the study of teamwork, to seek insights into enhancing the effectiveness of hospital ethics committees and clinical ethics committees (CECs), with the aim of contributing to heath-care organizations’ effective and efficient decision-making and operation. Based on an analysis of the obstacles that stand in the way of ethics committees’ (ECs’) efficient functioning, five specific conditions for EC success are brought forth. A couple of practical (...) tools for their attainment are proposed. The article suggests that the construction of those committees, as well as the working procedures that may render them effective, should be flexible and made adaptable to the specific assignment or case, which is dealt with by that committee, at the time; and that the optimal set of procedures to adopt, throughout the working sessions of ECs, are those which will gear the committee with the means to contribute to the eventual materializing and finalization of a quality and practical set of decisions; for the benefit of patients, their families, health-care organizations and the community, alike. (shrink)

Croatia is a transitional society in that it is a country emerging from a socialist command economy toward a market-based economy with ensuing structural changes of a social and political nature—some extending into the healthcare system. A legacy from our past is that, until now, Croatian healthcare institutions have had no real experience with clinical ethics support services. When clinical cases arise presenting complex ethical dilemmas in treatment options, the challenges presented to the medical team are substantial. The case described (...) below recently occurred on a ward in a university hospital in Croatia. An unexpected request from the patient’s parents created a number of issues that needed to be addressed by the medical team, which was made more difficult by the lack of clinical ethics support services. Such cases press the question currently being debated as to what type of ethics support services would be suitable for Croatia and why. (shrink)