Clinical ethics committees and clinical ethics services. A proposal for Italy

In Italy, the implemented reform concerning the reorganisation of research ethics committees has rekindled the debate on the need to also regulate ethics consultation in relation to ethical issues that may arise in clinical practice. The solutions put forward to date are essentially threefold: to assign research ethics committees also the task of dealing with the ethical aspects of clinical practice; to introduce ethics committees specifically set up for clinical practice; to plan a multilevel intervention, assigning to clinical ethics services the task of providing ethics consultation at the bedside and training of healthcare professionals, and to clinical ethics committees the role of reviewing consultation and drawing up general recommendations on clinical ethics issues. This contribution is therefore intended to analyse and offer an interpretation on this topic. To this end, we will first analyse the documents produced by the Italian National Bioethics Committee and the studies conducted in Italy in recent years that have investigated the attitudes of healthcare professionals on the subject. Secondly, we will present the current scenario and, in particular, the tasks and characteristics of ethics consultation carried out in healthcare institutions. Finally, based on what has been outlined, we will provide an operational proposal developed within the Clinical Ethics Research Centre of the University of Insubria.