Quality Control for Hospitals' Clinical Ethics Services: Proposed Standards

Abstract

Hospital ethics committees have become widespread over the last 25 years, stimulated by the Quinlan decision of the New Jersey Supreme Court, the report of a President's Commission, and most recently by the Joint Commission on Accreditation of Health Care Organizations (JCAHO), which now man dates that each hospital seeking accreditation have a functioning process for the consideration of ethical issues in patient care. Laws and regulations in several states require that hospitals establish ethics committees, and some states stipulate that certain types of cases and disputes be taken to such committees. At least one state grants legal immunity to those who implement recommendations of an ethics committee.

Evaluating assessment tools of the quality of clinical ethics consultations: a systematic scoping review from 1992 to 2019

“…Desired personal attributes included tolerance, patience, compassion, honesty, self-knowledge, courage, prudence, humility, and integrity [70,[78][79][80]. Professional proficiencies sought after included prior training and experience with CEC practices [7,16,79,[81][82][83][84][85][86], ethico-legal knowledge [69, 78-81, 83, 86-96] and active involvement in promoting awareness of ethical issues in the clinical environment [80,91,92]. An effective CEC consultant also showed interest in organizational ethics [7], educating and guiding others on ethical issues [80,91,92] and aligning expectations and practice with institutional and CEC standards [82,86].…”

Clinical ethics committees and the formulation of health care policy

“…Provided that CECs work to such principles and their members are trained to do so then there is every reason to believe they can make an extremely positive contribution to improving clinical practice and the general quality of health care. 39 At their best, research ethics committees have made just such a contribution to good research practice in clinical medicine. Resistance to the creation of CECs risks, therefore, the appearance of self serving.…”

Project Examining Effectiveness in Clinical Ethics (PEECE): phase 1—descriptive analysis of nine clinical ethics services

“…Strategic plans generate the direction for the daily activities of a particular service or agency 18 and like mission statements provide a guide for measuring accountability. 17 Given that six sites in this study do not have written strategic plans with clearly identified goals and objectives in place, the effectiveness of these clinical ethics services in meeting organisational goals and objectives is difficult to ascertain. In phase 2, the relation between effectiveness and accountability structures will be explored from the perspectives of a number of key stakeholders.…”