BACKGROUND Evaluating clinical ethics support services (CESS) has been hailed as important research task. At the same time, there is considerable debate about how to evaluate CESS appropriately. The criticism, which has been aired, refers to normative as well as empirical aspects of evaluating CESS. MAIN BODY In this paper, we argue that a first necessary step for progress is to better understand the intervention(s) in CESS. Tools of complex intervention research methodology may provide relevant means in this respect. In a first step, we introduce principles of "complex intervention research" and show how CESS fulfil the criteria of "complex interventions". In a second step, we develop a generic "conceptual framework" for "ethics consultation on request" as standard for many forms of ethics consultation in clinical ethics practice. We apply this conceptual framework to the model of "bioethics mediation" to make explicit the specific structural and procedural elements of this form of ethics consultation on request. In a final step we conduct a comparative analysis of two different types of CESS, which have been subject to evaluation research: "proactive ethics consultation" and "moral case deliberation" and discuss implications for evaluating both types of CESS. CONCLUSION To make explicit different premises of implemented CESS interventions by means of conceptual frameworks can inform the search for sound empirical evaluation of CESS. In addition, such work provides a starting point for further reflection about what it means to offer "good" CESS.

中文翻译：

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我们了解干预措施吗？什么复杂的干预研究可以教给我们如何评估临床伦理支持服务（CESS）。

背景技术评价临床伦理支持服务（CESS）已被认为是重要的研究任务。同时，关于如何正确评估CESS的争论也很多。发表的批评指的是评估CESS的规范和经验方面。主体在本文中，我们认为取得进展的第一步必要步骤是更好地了解CESS中的干预措施。复杂干预研究方法论的工具可以在这方面提供相关手段。第一步，我们介绍“复杂干预研究”的原理，并展示CESS如何满足“复杂干预”的标准。在第二步中，我们为“应要求提供道德咨询”开发了一个通用的“概念框架” 作为临床伦理实践中许多形式的伦理咨询的标准。我们将此概念框架应用于“生物伦理学调解”模型，以根据要求明确阐明这种形式的伦理学咨询的具体结构和程序要素。在最后一步中，我们对两种不同类型的CESS进行了比较分析，这两种类型的CESS均已接受评估研究：“积极的道德咨询”和“道德案例审议”，并讨论了评估这两种类型的CESS的含义。结论通过概念框架明确实施CESS干预措施的不同前提，可以为寻求CESS可靠的经验评估提供依据。此外，此类工作为进一步思考提供“良好” CESS的含义提供了起点。