Successes and Failures of Hospital Ethics Committees: A National 
Survey of Ethics Committee Chairs

McGee, Glenn; Spanogle, Joshua P.; Caplan, Arthur L.; Penny, D. Riha; Asch, David A.

doi:10.1017/s0963180102001147

Cited by 49 publications

(36 citation statements)

References 11 publications

(7 reference statements)

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“…Both types of ethics committees are well developed and present in the U.S., although lately there is a great debate on the problems and drawbacks facing development of the HEC (19,20).…”

Section: Resultsmentioning

confidence: 99%

Ethics Committees in Croatia in the Healthcare Institutions: The First Study about their Structure and Functions, and some Reflections on the Major Issues and Problems

2006

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“…Both types of ethics committees are well developed and present in the U.S., although lately there is a great debate on the problems and drawbacks facing development of the HEC (19,20).…”

Section: Resultsmentioning

confidence: 99%

Ethics Committees in Croatia in the Healthcare Institutions: The First Study about their Structure and Functions, and some Reflections on the Major Issues and Problems

2006

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“…(McGee, Spanogle, Caplan et al, 2002;Carter, 1988;LevineAriff, 1989;Mason et al, 1989;Hoffmann, 1991;Lappetito and Thompson, 1993). Frequent roles include ethics consultation (92% of ECs), any education (96%), and policy review (71%); they are among the top three major roles in 77%, 71%, and 40% of ECs respectively.…”

Section: Commentmentioning

confidence: 99%

“…Even this published data, however, may not apply to most current ECs because of the age of the survey (Younger, Jackson, Coulton et al 1983), because the characteristics of the surveyed hospitals are not specified (McGee, Spanogle, Caplan et al, 2002), or because they are limited to specific types of hospitals: U.S. Army (Carter, 1988), children's (Levine-Ariff, 1989, New York City (Mason, Johansson, Fleming et al, 1989), hospitals with legally mandated ECs (Hoffmann, 1991), large teaching hospitals (Scheirton, 1992), Catholic (Lappetito and Thompson, 1993), or state mental (Backlar and McFarland, 1994). Rarely do they report members' training in bioethics (Hoffmann, 1991), who appoints the EC chair (Scheirton, 1992;Lappetito and Thompson, 1993) or members (Levine-Ariff, 1989;Lappetito and Thompson, 1993;Backlar and McFarland, 1994); only one provides details about case consultation (Levine-Ariff, 1989).…”

mentioning

confidence: 99%

Hospital Ethics Committees: A Survey in Upstate New York

Milmore

2006

HEC Forum

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This survey describes in detail ethics committees (ECs) at acute care hospitals in Upstate New York. It finds that in just two years (1984 and 1985), following the Baby Doe controversy and the Report of the President's Commission, 40% of urban ECs and 37% of university ECs were formed. One half of rural ECs formed in 1992-1995, following the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requirement of access to ethics consultation. Generally, ECs are committees of the powerful within the hospital; the administration or the medical staff is the organizational parent of 73% of ECs. These groups appoint 80% of EC chairs and 79% of members; they constitute 45% of the membership. Most EC members (81%) lack even rudimentary formal training in bioethics, yet only 18% of ECs consider member education a major role. Many ECs are rather inactive: 53% meet less than every other month and 61% have fewer than six case consultations in the prior year. On the basis of this survey's findings, suggestions are offered to improve the credibility of these ubiquitous committees as stewards of bioethics, rather than of the powerful within the hospital.

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“…Mit der ethischen Weiterbildung - innerhalb des Komitees, für Krankenhausangestellte, Patienten und die allgemeinheit -haben KeDs nach eigener einschätzung den meisten erfolg [16]. W. robinson sieht in der Weiterbildung eine der Hauptaufgaben von KeDs: "Der Prozess, den leuten zu erlauben, ein Mitspracherecht in ihrer institution zu haben, lehrt sie, aufmerksamer zu sein gegenüber ethischen Fragen, die dauernd aufkommen.…”

Section: Tätigkeiten Klinischer Ethikdiensteunclassified

Which model of ethics consultation services best serves its goals? – Experiences from the USA

Winkler

2009

Ethik Med

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3O r i g i n a l a r b e i t Zusammenfassung in den USa haben sich im Wesentlichen drei verschiedene Organisationsformen klinischer ethikberatung entwickelt: der einzelne berater, das große Komitee und das beratungsteam teilweise mit rückbindung an ein größeres Komitee. bislang gibt es jedoch weder empirische Daten noch ein ergebnis der anfänglichen theoretischen Diskussion, ob es ein favorisiertes Modell für die klinische ethikberatung geben sollte und welches dieses sei. Dieser artikel argumentiert, dass die Vorzüge, nachteile und die erfolgsfaktoren der verschiedenen Organisationsformen in abhängigkeit von der Zielsetzung klinischer ethikdienste (KeD) bewertet werden müssen. Diese Zielsetzung kann auf einem Spektrum vom "Patientenanwalt" bis zum "gewissen der institution" angesiedelt sein. Die Zielsetzung bestimmt dabei aufgabenschwerpunkte, Zusammensetzung, die favorisierte Organisationsform und wünschenswerte Standards. Die Untersuchung stützt sich zum einen auf die analyse von interviews mit fünf Vorsitzenden klinischer ethikkomitees von Harvard lehrkrankenhäusern in boston, die jeweils etwa 20 Jahre erfahrung in klinischer ethikberatung mit den drei unterschiedlichen Modellen gemacht haben. Zum anderen basiert sie auf der rezeption der literatur und empirischen Studien zu KeDs in den USa und Deutschland. insgesamt scheint das Konsilteam mit rückbindung an ein Komitee am besten geeignet, die behandlung einzelner Patienten und das ethische bewusstsein einer ganzen Organisation zu verbessern. es vereint die Vorteile der anderen beiden Modelle auf sich, ohne unter deren Schwächen zu leiden.Abstract Definition of the problem although ethics consultation services (eCS) are commonplace in hospitals in the United States there is a lack of empirical data regarding which model of eCS (individual consultant, committee, or team) best achieves its goals. the initial debate about a potential best model ebbed away without a consensus. this article argues that the goals of eCS range from being "the patient's advocate" to "the conscience of the institution". the article discusses which model is best equipped to achieve the respective goal and which tasks, composition of eCS and standards should follow from the goal. Arguments The argument is based, firstly, on the analysis of interviews with five chairs of ethics committees of Harvard teaching hospitals. All of them bring 20 years of expertise in ethics consultation with all three consultation models to the table. Secondly, the article reviews the relevant literature and empirical studies about eCS in the US and germany. Conclusions In sum the model of a small consultation team affiliated to a larger committee seems best equipped to change individual patient care and the ethicality of an organisation. this model covers most of the goals of eCS, retains the virtues of both - committees and consultants - without succumbing to the limitations of either.

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Successes and Failures of Hospital Ethics Committees: A National Survey of Ethics Committee Chairs

Cited by 49 publications

References 11 publications

Ethics Committees in Croatia in the Healthcare Institutions: The First Study about their Structure and Functions, and some Reflections on the Major Issues and Problems

Ethics Committees in Croatia in the Healthcare Institutions: The First Study about their Structure and Functions, and some Reflections on the Major Issues and Problems

Hospital Ethics Committees: A Survey in Upstate New York

Which model of ethics consultation services best serves its goals? – Experiences from the USA

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