A National Study of Ethics Committees

Abstract

Conceived as a solution to clinical dilemmas, and now required by organizations for hospital accreditation, ethics committees have been subject only to small-scale studies. The wide use of ethics committees and the diverse roles they have played compel study. In 1999 the University of Pennsylvania Ethics Committee Research Group (ECRG) completed the first national survey of the presence, composition, and activities of U.S. healthcare ethics committees (HECs). Ethics committees are relatively young, on average seven years in operation. Eighty-six percent of ethics committees report that they played a role in ongoing clinical decision making through clinical ethics consultation. All are engaged in developing institutional clinical policy. Although 4.5% of HECs write policy on managed care, 50% of HEC chairs feel inadequately prepared to address managed care. The power and activity of ethics committees parallels the composition of those committees and the relationship of members to their institutions. The role of ethics committees across the nation in making policies about clinical care is greater than was known, and ethics committees will likely continue to play an important role in the debate and resolution of clinical cases and clinical policies.

Clinical Ethics Support in Contemporary Health Care

“…Most studies of ethics support services have sought to establish aspects such as: the prevalence of support services, their type, structure, composition, main functions, activities and processes (see for example McGee et al, 2001;Slowther et al, , 2004Slowther, McClimans, and Price, 2012;Godkin et al, 2005;Milmore, 2006;Fox, Myers, and Pearlman, 2007;Frewer and Fahr, 2007;Swetz et al, 2007;Pedersen, Akre, and Førde, 2009;Romano et al, 2009;Whitehead et al, 2009;Kesselheim, Johnson, and Joffe, 2010;Gaudine et al, 2010;Nelson et al, 2010b;Tapper et al, 2010;Moeller et al, 2012). What these studies mostly show is the diversity of CES services.…”

Er kliniske etikk-komiteer i den kommunale helse- og omsorgstjenesten bærekraftige?

“…Kliniske etikkomiteer er en etablert tjeneste for etikkstøtte i helsetjenesten internasjonalt (McGee et al 2001;Slowther, Hope, Ashcroft 2001). Stortinget besluttet i 2000 at alle helseforetak skal ha en klinisk etikkomite (Førde & Thorleifsson 2003).…”

Developing clinical ethics committees

“…Even in the USA this is not clear. 15 Since ethics concerns what we do (everything we do), there is a potential for a group of like-minded enthusiasts to pronounce on an enormous range of areas in which they have no special expertise. The competencies needed to serve on such a committee remain undefined; the role of the lay member, in contrast to those in research ethics committees, is not clear, especially if individual case problems are referred; nor is the position of CECs in clinical governance and the quality agenda agreed.…”