Ethics Committee

COMEC is committed to fostering an ethical climate open to debate on issues of ethical and moral relevance at the institutional level.

Purpose and institution

The Commission on Clinical Ethics of the Cantonal Hospital Corporation (COMEC) strives to:

  • Foster an ethical climate open to debate on issues of ethical and moral relevance at the institutional level.
  • Promote the identification of ethical or moral issues by offering active advisory support by explaining possible strategies to resolve them.
  • To safeguard respect for the dignity, rights and values of the patient in an attempt to reconcile them with the professional and personal values and beliefs of caregivers.
  • Ensure, within the discussions that have occurred internally, the quality of decisions, practices and the level of depth of reflection.
  • Foster interprofessional and interdisciplinary collaboration.
  • Ensure transparency and traceability of decisions.
  • Ensure, within the institution, ethics counseling, continuing education in clinical ethics for staff members, and promote research in the specific field.

Useful information

Accessibility

If situations inherent to care raise conflicts of values, EOC staff, patients, and their representatives may contact the COMEC at any time.
Specific requests for counseling should be made according to the provisions defined by the COMEC, which are available at the departments of care and posted on the EOC website.
Similarly, Services and Institutes of the EOC that should see general problems inherent in aspects of clinical ethics may avail themselves of the advice of the COMEC.

Excerpt from the Regulations Concerning the Establishment of the Clinical Ethics Commission (COMEC) dated 06/13/2003 (rev. 03/01/2023)

Skills

In particular, the COMEC has the following responsibilities:

  • Elaborate opinions aimed at favoring ethical order solutions upon explicit request, referring to specific clinical situations.
  • Elaborate opinions and proposals for ethical order solutions-autonomously or upon specific request-on issues that assume ethical or moral relevance at the institutional level.
  • Support and assist treating teams who request it in the ethical decision-making process.
  • To suggest independently or at the request of the Executive Board or individual Services/Institutes of the EOC, general, ethical opinions or recommendations concerning the management of situations that may arise in hospital clinical practice.
  • Ensure continuing education in clinical ethics for hospital staff.
  • To support research in bioethics, with special emphasis on the area of clinical ethics.
  • To disseminate the culture of clinical ethics in the population.
  • To ensure the visibility of its activities through a systematic information strategy and through regular collaboration with the Journal for Medical Humanities.
  • COMEC does not carry out any oversight activities within the EOC.
  • The review and approval of clinical trial and research programs are not the responsibility of the COMEC but of the Ethics Committee in accordance with Article 10 of the LSan.


Excerpt from the Regulations Concerning the Establishment of the Clinical Ethics Commission (COMEC), 06/13/2003 (rev. 03/01/2023)

Advice and opinions

The COMEC provides support in ethical discussions and develops specific and general advice, opinions, suggestions, and recommendations independently and autonomously.
The opinions and suggestions of the COMEC on each individual case do not replace the decision of the treating team, which remains responsible for the interventions and procedures to be adopted with respect to the patient.
Although the recommendations of the COMEC do not have legal force, they are inspired not only by the principles of clinical ethics but also by compliance with current legal regulations and the principles defined by the recommendations of the Swiss Academy of Medical Sciences (SAMS).
The COMEC may use consultants from within or outside the EOC.
The COMEC does not replace the legal advice nor the Mediation Service, but works closely with the Services in charge of these activities by providing its contribution if it is requested.

Excerpt from the Regulations Concerning the Establishment of the Clinical Ethics Commission (COMEC), 06/13/2003 (rev. 03/01/2023)

Confidentiality

Requests that come to the COMEC and opinions issued by the COMEC are treated with full respect for privacy. COMEC members and their consultants are required to maintain the confidentiality of the opinions expressed during the sessions.
The intervention of the COMEC in counseling cases involving individual patients, as well as relevant items regarding this intervention, must be included in the patient's medical record.
The opinions, proposals and recommendations of the COMEC may be requested by the EOC Executive Board.

Excerpt from the Regulations Concerning the Establishment of the Clinical Ethics Commission (COMEC), 06/13/2003 (rev. 03/01/2023)

Medical Humanities

The journal for Medical Humanities, published by the Sasso Corbaro Foundation in collaboration with the Cantonal Hospital Authority, is the result of a long journey of study around the humanities and care in its most diverse forms.

COMEC collaborates with the Sasso Corbaro Foundation in editing the online journal Pathways in the Medical Humanities and the semi-annual publication Quaderni per le Medical Humanities.

Requests for counseling from EOC patients (or their family members)

Requests for consultation from EOC patients (or their families) or their representatives are forwarded to the COMEC either through the Quality Service of the involved institution or directly by the person concerned.

In the case of a request for an opinion from a patient or his or her representatives, the chairperson, vice-chairperson, or contact person of the hospital's COMEC, in consultation with the Quality Service of the institution involved, will assess whether the case falls within the competence of the COMEC.

If the COMEC is found to be competent, the chairman (or his or her deputy) within 24 hours will be responsible for:

  • Inform the applicant that the request has been received.
  • If applicable, arrange a meeting between the requester and a COMEC delegation to gather additional information useful in analyzing the case and obtain permission to hear the other party(ies) in the case of a conflict of values involving another person or persons.


Having consulted the members, the COMEC shall issue its decision as the result of the opinion shared by the majority of the members participating in the consultation. If the decision is not fully concurred with, the COMEC report also records the dissenting opinions. All opinions are documented and distributed to the members.

Opinions and ethical proposals formulated by the COMEC in relation to individual, or ordinary general, or urgent clinical situations are signed by the chair or vice-chair and must contain the plurality of arguments developed during the discussion. Their drafting is the responsibility of the secretary or a member of the COMEC.

Opinions and proposals of the COMEC of ethical order in relation to individual clinical situations shall be included in the medical record and communicated to the applicant and the attending physician in charge of hospital care.

Excerpt from the Operating Provisions of the Clinical Ethics Commission of the EOC (COMEC) dated 02.12.2013 (rev. 01.03.2023) - Annex 1 to the Regulations Concerning the Establishment of the Clinical Ethics Commission (COMEC)

Useful Links

President

Members

  • Inf.

    Valentina Di Bernardo

    Vicepresidente

  • Avv.

    Bruno Balestra

  • Inf.

    Tanya Balestra

  • Dr. med.

    Michele Bedulli

  • Dr.ssa med.

    Paola Borella

  • Dr.ssa med.

    Raffaella Ada Colombo

  • Dr.ssa, PhD

    Marta Fadda

  • Dr. phil.

    Nicola Grignoli

  • PD Dr. med.

    Mattia Lepori

  • Dr. med.

    Michael Llamas

  • Prof. Dr. med.

    Paolo Merlani

  • Dr. med.

    Marco Previsdomini

  • Prof.

    Fabio Pusterla

  • Dr., PhD

    Simone Romagnoli

  • RN, BScN, MScN, PhD

    Tiziana ML Sala Defilippis

The English version of this page was created with the aid of automatic translation tools and may contain errors and omissions.
The original version is the page in Italian.