The current scenario of clinical ethics in Italy

Background: Italy has seen limited growth and institutionalization of clinical ethics activities in its territory. Only a few observational studies were conducted in Italy to assess the state of the art of clinical ethics services and activities. Aim: We sought to gain a broad and comprehensive understanding of the state of the art as perceived by Italian healthcare institutions and facilities. Methods: We prepared a questionnaire comprising of twelve close-ended and six open-ended questions. We sent it to all Local Healthcare Authorities (Aziende Sanitarie Locali, ASL), all private Scientific Institutes for Research, Hospitalization and Healthcare (Istituti di Ricovero e Cura a Carattere Scientifico, IRCCS), and all hospices throughout Italy. Out of 380 facilities, 90 of them (22.5%) responded to it. Results: All answers revealed interesting data. Among them, the ones that stood are: when asked who they turn to when an ethical dilemma arises, 27.7% of the respondents checked more than two answers, thus showing that there is not one clear and unequivocal body of reference. When asked if there are standard procedures, 55.4% of the respondents declared that there are no standard procedures. Only 4.4% of respondents declared the method of analysis being used. 53.3% responded that their hospital or healthcare facility does not regularly offer training activities and formation to deal with ethical dilemmas Conclusion: The three topics that stand out are a great fragmentation, the need to formalize and establish dedicated services to take care of ethical dilemmas and to offer training and formation to healthcare providers.