"Ethics must always prove themselves in everyday life."

To mark the occasion, Sté Haltiner talks to the two co-heads: Kathrin Hillewerth, Co-Head of Surgery at Zollikerberg Hospital, and Jean-Daniel Strub, Head of the Neumünster Institute.

What is the Ethics Forum all about?

Questions that, even after years of professional experience, you can't say casually: "That's just how it's done." For example: What does self-determination really mean for people in general and for people with cognitive impairments in particular? How do we deal with enquiring about and documenting resuscitation decisions at the foundations? And how do we talk about dying wishes without making hasty judgements?

Why do we need a forum like this?

Because ethical issues in medical and nursing practice need a place where they can be discussed, examined and jointly reflected upon in a calm, interprofessional and interdisciplinary manner, taking into account all organisational perspectives. Many areas in which this question arises are - fortunately - not explicitly regulated by law. There may be medical ethics guidelines or overarching standards, but ultimately it is the responsibility of the institutions themselves to determine how they deal with the issues in concrete terms, what directives they issue and what support is available for professionals. These issues are discussed in the Ethics Forum at our foundation.

Who is involved in the Ethics Forum?

People from very different areas: carers, doctors, pastoral care, a colleague from the Centre for Mental Health, as well as those responsible for the "Assisted Living" business area and the two of us as ethics experts. When specific issues arise, we bring in specialists from the relevant areas as guests. The Ethics Forum is not an elitist body, but a place for doubt, experience and the courage to question one's own attitude from time to time.

What makes our forum special?

Our Ethics Forum does not differ significantly from the so-called ethics structures that other healthcare organisations are familiar with. In comparison, we are perhaps a little more practically orientated and it is a huge advantage that colleagues from so many fields of practice can take the time to participate in seven meetings per year. This makes it possible to bring ethics into practice and address questions such as How much closeness is professional? When does care become paternalism? And what happens when values collide, such as the protection of life and autonomy? Questions arising from increasing life expectancy are also addressed: How do we organise a long life that not only lasts, but also has meaning? How do we take account of self-determination even in sensitive borderline situations - without exposing employees to burdens that are incompatible with their values? It is particularly important for employees to know where they can turn to with ethical questions in everyday life - and that they learn to use the opportunity to convene ethical case discussions as a space for reflection. One thing is clear: ethics must ultimately always prove itself in everyday life. And this requires the involvement of all important areas.

Is the Ethics Forum also known outside the organisation?

Yes. At Gesundheitswelt Zollikerberg, we organise regular ethical case discussions on the wards and offer further training on ethical issues. We are also present outside the organisation with case discussions, presentations and further training on ethical issues. We are also actively involved in the recently established regular dialogue between ethics officers at Zurich hospitals.

Last question: What is the point of questioning your own attitude?

Counter question: Can there be good medicine and good care if we don't do this? Attitudes can and must evolve. Ethics is always part of society as a whole, and many questions - now, for example, in dealing with artificial intelligence - only arise in new ways due to new technological possibilities. It is therefore essential to work on one's own attitude and incorporate other points of view. And it ensures a holistic approach in favour of our patients, residents and employees.

To mark the 200th meeting of the Zollikerberg Healthcare World Ethics Forum, a "Lunch & Learn special" will be held in the yurt on Tuesday, 26 August 2025, 12.30 - 13.15, where topics and the importance of ethics at Zollikerberg Healthcare World can be discussed with members of the Ethics Forum. You are cordially invited.