Policy Brief: Establishing Clinical Ethics Committees (CECs) to address moral conflicts in Tanzania’s hospitals

Studies have shown that moral conflicts are an inseparable part of daily clinical practice (Beauchamp & Childress, 2019; Blanco Portillo et al., 2021; Kuhumba et al., 2024; Miljeteig et al., 2019; Rasoal et al., 2016). A moral conflict in healthcare can occur when decisions are made, in cases of uncertainty about what should be done, in case of a disagreement about decisions, or when there is a conflict between ethical principles and values. For example, moral conflicts related to questions such as the extent of decision-making authority a next of kin hold regarding a patient’s care. Several studies conducted in the Sub-Saharan context have identified numerous moral challenges in healthcare. These challenges include insufficient medical resources and the economic conditions of patients and their families. Additionally, difficulties arise in disclosing medical information and maintaining confidentiality. Cultural and religious perspectives significantly shape healthcare delivery, especially in areas like palliative care and end-of-life decision-making. Conflicts often occur between standard medical treatments and traditional medicine. Furthermore, there are prevalent issues concerning the withdrawal of treatment and the minimization of healthcare. Our research project has identified several of these moral challenges as noted in studies by (Aboud et al., 2018; Athanas et al., 2020; Defaye et al., 2015; Ewuoso et al., 202; Pancras et al., 2018; Sippel et al., 2015; Vedasto et al., 2021; Kuhumba et al., 2024).