The What, How, and Why of Ethics Committees (1984)
Sheed and Ward
This early work by Jack Glaser, STD, and Ronald Cranford, MD, discusses the ethics committee as a body to translate theory to reality, and to facilitate consensus and good decisions. They say its functions are to educate, to develop policies and procedures, to act consultatively, and to provide retrospective review. The program consists of host Jack Glaser speaking with Ron Cranford as they sit and talk together. Dr. Cranford states that he believes that ethics committees will increase in importance. He believes that termination of treatment questions will dominate for the next 5-10 yeas, but that other issues will come forward. DRGs (diagnostic related groups) pose tremendous dilemmas of undertreatment for cost containment. Institutions needs to look at both cost containment and best patient interest. Ethics committees could try to balance these concerns. Ethics committees serve to translate theory to reality; facilitate consensus and bring about good decision making. Cranford indicates that there are four functions for ethics committees: 1) education; 2) develop policies and procedures; 3) consult and advise; and 4) retrospective review. The Committee has to develop legal and ethical expertise...the problem is that developing this expertise is very time-consuming. The Committee should not act as if these are police policies, but rather facilitate a collegial, cooperative atmosphere that encourages working together with good behavior and good models for doing so. Physician objectives to Ethics Committees are that they will impose ideas, narrow decisions by making specific recommendations, and that they don't want to be told what to do. The ethics committees don't have a corner on the morality market. Membership should draw from many disciplines and be from 10-25 members, including physicians and nurses (from all departments), social workers, administrators, and eventually from the community. Cranford believes that institutions should have ethics committees.
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Facilitating Medical Ethics Case Review: What Ethics Committees Can Learn From Mediation and Facilitation Techniques West, Mary Beth; Gibson, Joan McIver (1992)Medical ethics committees are increasingly called on to assist doctors, patients, and families in resolving difficult ethics issues. Although committees are becoming more sophisticated in the substance of medical ethics, little ...