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Abstract: International policies regulating clinical ethics committees'' (CEC) roles are non-existent. Nonetheless, CECs have established themselves in several countries and there exist striking differences in the way these work. This international practice variation stems from the ways CECs developed, within particular legal, political, social and professional contexts. National guidelines and normative documents have been published in many countries regarding CECs. To better understand CECs'' evolution and differences in various countries, we reviewed guidelines, position statements and normative papers which describe and frame the development of CECs in the United States, the United Kingdom, Canada and France. Systematic content analysis addressed guideline development, CECs'' roles, consultation methods and CEC members'' education requirements. Differing contexts informed the ways in which guidelines were developed. American CECs, established within a strongly litigious context are perceived to play strong decision-making roles, whereas British CECs, encouraged by clinicians, endorse a more supportive model. Canadian guidelines focus on the role of the ethicist, while the French model is interested in a theoretical interdisciplinary approach. This analysis shows important challenges facing the implementation of accountable CECs in different contexts and can help inform future policy development. [Copyright &y& Elsevier]

On the basis of a study of American, British and Canadian records, this article examines the relationship of France to the negotiation of the North Atlantic Treaty from the perspective of the ‘ABC’ countries, particularly Canada. How did the perceived vulnerability of France influence the approach of the members of the ‘North Atlantic Triangle’ to the justification, timing and contents of the proposed pact? How did France's inclusion in Western Union and its exclusion from the preliminary talks in the Pentagon affect American, British and Canadian attitudes to the development of the draft alternatively known as the ‘Pentagon Paper’ or the ‘State Department Draft’? These questions are addressed, as well as the impact on the later ambassadorial talks of France's priority to immediate rearmament and its determination to include the departments of Algeria within the defensive perimeter of the North Atlantic Treaty Organisation. Finally, the article assesses the extent to which France and its requirements influenced the policies and actions of the Canadian government throughout the negotiation of the North Atlantic Treaty. [ABSTRACT FROM PUBLISHER]