Ethics Consults Part Deaux: Peer Review Instead?

Rosemary Flanigan

June 24, 2010

Thanks to all of you who have been thinking with me about that ethics committees ought NOT consult on. I think ethics committees are so uniquely related to their institutions—and different institutions (and different histories of the committee) permit and even encourage different types of participation.

One physician blogger responded that we ought “not 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 also to standards of medical or surgical practice. . .these matters belong in peer review.”

That may be so, but the beginning of such cases could arise from an ethics consult with its eventual resolution coming out of peer review. DOES ANYONE AGREE?

I have been reading the articles in Cambridge Quarterly about bioethics in Scotland, Japan, Croatia, Iceland, Pakistan, Italy and Israel. Guess what? Lots of the same problems as we have.

In a survey with over 500 internal practice, oncology, and intensive care specialists and associated nurses in Croatia, the following were “the most frequently faced dilemmas: uncertain or impaired decisionmaking capacity, limitation of treatment at the end of life, and disagreements among family members.”

Doesn’t that sound familiar?

So, upward and onward!!