Clinical ethics consultants competencies repertoire: A qualitative study

Abstract

Background

The healthcare system is characterized by increasing complexity. As moral challenges in healthcare become increasingly frequent, healthcare professionals, patients, and families turn to Clinical Ethics Consultants (CECs) for support. This evolving scenario highlights the importance of establishing clear professional standards and competencies for consultants to ensure qualified, transparent, and ethically rigorous support.

Research aim

To define a repertoire of technical-professional and transversal competencies for CECs.

Research design

A qualitative descriptive approach, employing the “Interview to the Double” and Hierarchical Task Analysis (HTA) techniques.

Participants and context

Twenty-four Italian CECs, with interdisciplinary professional backgrounds were asked to imagine a ‘Double’ taking their place, to whom they would provide detailed instructions on activities, decisions, and daily interactions during consultations. Subsequently, HTA was used to map elements hierarchically into competencies. The interviews continued until data saturation was reached.

Ethical considerations

The study was conducted in accordance with international ethical guidelines and approved by the local Ethics Committee.

Findings

Overall, 10 technical-professional and 12 transversal competencies were identified, encompassing 87 and 110 tasks, respectively, organized into 9 main areas of activity and 22 learning outcomes.

Discussion and conclusions

The national repertoire provides an operational tool that combines standardization and flexibility, makes the practice of CECs visible, supports the certification of CECs’ competencies, the development of transparent and evidence-based training pathways, and ensures that ethics consultations are conducted with responsibility, methodological rigor, and ethical grounding. In continuity with international experiences, it contributes to conceptual enrichment, strengthens scientific legitimacy, and supports the professionalization process and the public recognition of the CEC’s qualification as an expert profession.