Experiences with remote ethics consultation: a qualitative study with ethics consultants in Germany

The use of remote methods such as video conferencing has the potential to improve access to ethics consultations, particularly in outpatient and rural healthcare settings. Although their use has increased since the COVID-19 pandemic, little is known about ethics consultants’ experiences with remote consultations so far. We conducted three focus groups with 14 certified ethics consultants in Germany in October 2024 to investigate their experiences with, and attitudes towards, remote ethics consultations. The data was analysed using structuring qualitative content analysis. Participants reported experiences with a range of remote methods, including email and phone for short consultations, and videoconferencing for full ethics consultations. Videoconferencing was primarily used when in-person meetings were not feasible. Attitudes towards video-based consultations varied, and consultants with more experience with this technology tended to view it more favourably. Reported advantages included improved accessibility, especially in rural areas, easier scheduling, and the ability to involve additional stakeholders. Disadvantages included technical challenges and concerns about privacy. Participants reported that video-based ethics consultations reduce non-verbal communication and emotional expression. According to some, this made video consultations more structured and egalitarian, while others found this disadvantageous. Participants emphasised the need for specific preparation for video-based ethics consultations, such as ensuring adequate technical set-up or assigning roles to monitor emotional dynamics. Possible challenges regarding the involvement of patients and relatives in remote consultations were noted. While some participants viewed remote formats as more suitable for less emotionally intense cases, others saw no inherent limitations regarding consultation topics. Our findings indicate that ethics consultants regard video-based remote consultations as a viable alternative when in-person meetings are not feasible. The study identified specific communicative challenges that should be addressed in future training for ethics consultants. Further research is needed to ensure that the implementation of remote ethics consultation can realise its advantages and mitigate possible disadvantages. This includes exploring the perspectives of patients and relatives.