Hospital-based clinical ethics support in Latin America: a scoping review of committee, consultation, and hybrid models

Hospital-based clinical ethics support in Latin America encompasses committees, consultations and integrated service models, but the organizational evidence is dispersed. Objective: To map how these services are structured, accessed and delivered, and what contributions are reported in patient-specific ethical dilemmas. This scoping review followed JBI guidance and PRISMA-ScR. Searches in BVS/VHL, Scopus, PubMed/MEDLINE, Web of Science and SciELO were supplemented by backward/forward citation tracking, Google Scholar and targeted grey-literature searching. Studies were charted at report level and overlapping hospital publications were linked. The inventory contains 119 reports: 50 empirical, 27 institutional/descriptive and 42 conceptual/theoretical. Of 67 directly linked reports describing operating services, 47 non-overlapping operational analytic units were mapped. These comprised 41 committee-centred units​, three integrated-service, one hybrid, one team-consultation and one individual-consultation unit. End-of-life decisions, treatment proportionality, autonomy and clinical–family disagreements were recurrent themes. Data on access, response times, patient/family participation and evaluated outcomes were inconsistently reported. Regional evidence documents diverse organizational models and reported contributions of clinical ethics support services, although the available studies provide limited evidence on patient-level outcomes and clinical effectiveness.