UNESCO Emphasizes a Need for establishing Hospital Ethics Committees in Kenya

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UNESCO has been building and reinforcing linkages among ethicists, scientists, policy-makers, judges, journalists, and civil society to assist Member States in enacting sound and reasoned policies on ethical issues in science and technology. With a growing interest among Member States to establish Health Ethics Committees (HECs) at the local level – mostly in hospitals, long-term care institutions, hospices and, in a few cases, home-health care agencies, UNESCO continues to address the emerging ethical challenges by providing an intellectual forum for multidisciplinary, pluralistic and multicultural reflection on ethics of science and technology. This has even become an urgent and pressing need, especially since the COVID-19 pandemic outbreak that has magnified pre-existing challenges in healthcare systems worldwide, including in Africa.

In Kenya, a study on The Status of Hospital Ethics Committees in Kenya (2008) supported by UNESCO, was conducted in 2018 by the UNESCO Chair on Bioethics at Egerton University, in collaboration with the Kenyan National Commission for UNESCO, has already emphasized on the need for establishing HECs in Kenya. It reveals that, out of forty-four hospitals that were visited, none, which is 0%, had a bona fide HEC. This rapid assessment on selected public and faith-based hospitals further outlines that 10 out of the 44 hospitals (23%) had indicated having existing committees, most of which however, were not purposefully and structurally established to handle ethical dilemmas arising from clinical care. Besides, the study observed that none of the existing committees in all the hospitals surveyed had a person with formal training in ethics. For sure, the lack of personnel trained in ethics in hospital boards undermines the much-needed professionalism to addressing ethical dilemmas. This is even more important in the current COVID-19 pandemic. It is therefore without surprise that the study indicates that 100% of the respondents expressed favourable views on the creation of HECs in Kenya.

However, as recommended by the study, the reflection towards the establishment of HECs in Kenya should be done in consultation with key interested stakeholders of the health sector, notably the Ministry of Health, Council of Governors, Kenya Medical Practitioners Board, etc. 

It is in follow-up to this recommendation that on 25th January 2022, the Ministry of Health and the Kenya National Commission organized a sensitization of Ministry of Health and Council of Governors officials and health care practitioners and experts in a consultation meeting on the establishment of hospital ethics committees. Present at that meeting were representatives from UNESCO, WHO, members of the National Bioethics Committees, Research Scientists from the Kenya Medical Research Institute, Representatives from Hospitals, members of Bioethics Network of Kenya among others.

The meeting provided an opportunity for the experts to reflect on the importance, functions and challenges of HECs as well as suggesting mechanisms for their establishment, while making sure to avoid duplication of mandate with existing Committees, such as the Research Ethics Committees or the National Bioethics Committee.

There was a consensus to continue engaging with the partners to ensure a successful implementation of the committees, drawing from the expertise and experiences of hospitals such as Agha Khan University Hospital and Kenyatta Hospital.

It was also recommended to leverage on standards, principles and guidelines provided by UNESCO and contained in the Universal Declaration on the Human Genome and Human Rights (1997), the International Declaration on Human Genetic Data (2003), the Universal Declaration on Bioethics and Human Rights (2005), but also in the UNESCO Guide n1 on Establishing Bioethics Committees (2008).

UNESCO will continue supporting this process that falls within the Organization’s work on bioethics and ethics of sciences and technologies, and constitute a step forward, after the establishment of a National Bioethics Committee for Kenya based at NACOSTI, and a UNESCO Chair on Bioethics, established in 1998 at the Egerton University.