Ethics Committees in Outpatient Medical Practice: a Scoping Review

Introduction: This scoping review consolidates existing research on outpatient ethics committees (OECs). While inpatient or hospital ethics committees are well-researched and established, OECs are scarce in number and have received less attention from scholars, ethicists, and physicians, despite the increase in outpatient care utilization over the past two decades. Methods: We conducted a scoping review following the JBI Manual for Evidence Synthesis. Key information sources included MEDLINE PubMed, Embase, and Academic Search Complete. Gray literature searching was conducted through Web of Science Database, keyword searching in Google Scholar, and backward citation searching was utilized. Relevant articles were screened through the software Rayyan, and EndNote was used to manage references. Results: 38 papers were identified that analyzed OECs. Most commonly these papers either advocated for the creation of OECs (16/38) or offered suggestions for their formation (8/38). Of these 38 studies, 14 studies analyzed the outcomes of existing OECs, concluding that they benefit practitioners by facilitating timely ethical decision making, quality improvement, and easing the burden of individual decisions. Conclusion: Our review indicates that there is desire for, and benefits to, establishing OECs. The authors seem to agree that OECs empower staff, providers, and families during ethical decision-making. The authors note the benefit of a multidisciplinary approach to OECs by incorporating a diverse team of providers and staff. OECs can be utilized in ethics training, case study reviews, policy reviews, guideline development, and research. This review underscores the need for more support and exploration into OECs.