Wednesday, May 19, 2010

What ethics committees AREN'T

Rosemary Flanigan
May 19, 2010

When we think of what ethics committees AREN’T, the Center for Practical Bioethics has always held that they are NOT “prognosticating”, nor do they have the “authority of judicial review”, nor are they final decision-makers.

What they are are vehicles to create islands of reflection in which participants in the case consult or in the policy deliberation or in the educational endeavor can best achieve responsible—and responsive—activity.

Maybe the success of ethics committees cannot be gauged by case consultation activities; maybe their success is in each committee’s role in policy development and evaluation or their activities in educating the institution and its outreach regarding ethical dimensions of health and healthcare.

In past ethics committee workshops, I have tried to teach participants how to develop a policy, draft it, disseminate it for comments, re-work it and send it throughout the institution—and evaluate and re-evaluate it. I’ve used our Consortium’s guideline document, “Honoring Do-Not-Resuscitate (DNR) Orders during Invasive Procedures,” as a template.

1) Statement of the policy. (Because DNR orders in the past have been disregarded when patients underwent invasive procedures and because doing so is clearly incompatible with the Patient Self-Determination Act, a clear policy is needed.)

2) Statement of the ethical principles involved. (Autonomy, certainly, but also beneficience; and risks/benefits need to be considered)

3) Define terms.

4) State the procedures.

5) Implementation and Evaluation.

All of which leads me to ask: What policy work has your committee accomplished recently?



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