In 1976, the Medical Ethics Council of the Norwegian Medical Association suggested establishment of local ethics committees in Norwegian hospitals. In the United States in the 1980s, ethics consultation was commonly offered, following events where difficult ethical questions were poorly handled.
In 1993, Knut Ruyter, then phd-candidate at the Centre for Medical Ethics, initiated a project about clinical ethics committees (CEC) along with interested clinicians, hospital director, and the Ministry of Health and Social Services. The Ministry funded a 3-year trial at Gjøvik hospital, Rikshospitalet, and Ullevål hospital. It was required that the committees be cross-disciplinary. Otherwise, the committees themselves were free to decide their own composition, mandate, scope and methods, allowing for adjustment to local needs for ethics support. Instead of choosing ethics consultations by «ethics experts» (as was common in for instance the US), the decision was made to start a «bottom-up» process, involving the staff, and accomodating to their needs for ethics reflection in clinical settings.
The first CECs in Norway were established in 1996, after initiatives by clinicians at three hospitals, the Norwegian Medical Association, health authorities, and politicians. Today, all health trusts have at least one committee. We have over 40 committees in total. 3 of these are designated the field of mental health and addiction treatment.
The trial project was evaluated in 1998. The evaluation was positive, and recommended establishment of CECs in every national and regional hospital, and perhaps also in smaller hospitals and nursing homes. The evaluation and its recommendations were supported by Norwegian parliament, and in 2003 it was decided that all health trusts should have a CEC.