Responding to Moral Challenges in Clinical Practice: A Qualitative Assessment of Clinical Ethics Support Needs at Three Tanzanian Hospitals.

Healthcare professionals (HCPs) encounter various moral challenges in clinical practice. In various countries, clinical ethics support (CES) services are developed to support HCPs. One of these CES services is clinical ethics committees (CECs): they address moral challenges faced in healthcare settings and offer support for HCPs. However, in Tanzania, CECs have not yet been implemented. For implementation purposes, greater knowledge about how healthcare professionals navigate and respond to moral challenges, their understanding of CECs, and what they perceive as key needs for implementing CECs in hospitals, are valuable. This study explores HCPs' ways of dealing with their moral challenges at the moment and identifies key needs for establishing CECs in Tanzanian healthcare settings in the near future. The findings show that various implicit ways have been acknowledged as being useful in addressing moral challenges (e.g., regular meetings, family conferences, social welfare units, hospital procedures and guidelines, as well as consulting legal and management units). In addition, HCPs reported that a necessity exists for implementing more formal and systematic modalities to address moral challenges in clinical settings. The research in this paper has served as a preparation for establishing the first CEC in Tanzanian healthcare settings.