The establishment of a clinical bioethics service in a healthcare facility: the experience of ASST Lariana

In Italy, for almost thirty years now, there has been a debate on the opportunity to introduce forms of ethics consultation in the healthcare sector, and to assign the task of carrying out this activity to Clinical Ethics Committees and/or Clinical Ethics Services; however, to date, experiences of this kind are still very limited and a great deal of uncertainty remains as to the objectives, functions and institutionalisation of these bodies. This article illustrates the experience of one of the first Clinical Bioethics Services established as a hospital operational unit in Italy, starting from: a) the stages that made it possible to introduce this service; b) the ways in which the Service was established within the hospital; c) the functions covered by the Service. A preliminary analysis of the data collected in relation to the activities carried out in the first months of the Service’s implementation is then reported and, on the basis of this data, the following are identified: a) the strengths of the Service, among which the ongoing presence of an Ethics Consultant within the structure and in the operating units play a crucial role; b) the limits and aspects that need further implementation and/or improvement. Finally, in the light of current experience and in order to promote the establishment of Clinical Bioethics Services in Italy, the contribution emphasises the relevance of aspects such as the recognition of the professionalism of the Ethics Consultant, especially in terms of the skills and experience required to perform this role.