Friday, June 18, 2010

Ashley X: Where Ethics Committee Should Not Go?

Rosemary Flanigan, PhD
June 18, 2010

The new issue of Cambridge Quarterly of Healthcare Ethics arrived and I read the “Ethics Committees at Work” section first—as I always do. (Oftentimes I use the issues there and in the Hastings Center Report for my brown bag sessions.)

This time it was a request for the “Ashley Treatment” (remember the 2006 case of the profoundly developmentally compromised six-year-old in Seattle for whom the Children’s Hospital had attenuated growth, removed breast buds and performed a hysterectomy for the best interests of her parents to care for her).

This case concerned a nine-year-old on the East coast but a similar request.

And the commentaries were excellent: the pediatrician, while admitting initial lack of a moral compass, thought he could attenuate growth but no more; the philosopher and senior medical ethicist from Stanford argued that the surgery should be performed; the ethicist from the U.K. said, “Leave this case to the courts,” and John Paris and a law instructor showed why this case goes beyond the scope of an ethics committee, viz., that there are societal issues that demand a closer look at broader implications than could be expected of an ethics committee.

There are some places we should not go.

I need to refresh my memory if our ethics committee has refused case consults and on what grounds. Do you faithful readers have some examples—and not just of cases that clearly lacked ethical relevance. HELP!!!

Link: Podcast, Ashley X Revisited, Norman Fost, MD; John Lantos, MD; 8 minutes 20 seconds



Blogger Maurice Bernstein, M.D. said...

I would emphatically encourage hospital ethics committees not to engage in investigating and deciding on the ethical behavior of physicians as demonstrated in the context of the physicians' medical or surgical hospital practice. The ethics can be too closely related to also standards of medical or surgical practice. I think these matters belong in peer review. Hospital ethics committees can represent themselves to peer review committees as a resource of ethics and related law education but not to investigate, make decisions and take actions. ..Maurice.

Friday, June 18, 2010  

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