A large number of U.S. hospitals now have a committee to address the ethical issues raised by modern medicine and health care. Ethics committees (EC) are now being established in the unique setting of the nursing home. Although much has been written about Institutional Ethics Committees (IEC), few studies have engaged in qualitative research in multiple institutions and little research has focused on the long-term care (LTC) setting.
This study interviewed members of ethics committees in seven non-profit nursing homes. The goal was to examine the ~inner workings ~ of the committees.
All of tile committees had carried out self-education; then most moved into policy development. None were formally involved in case review or individual consultation. The group dynamics were described as positive and constructive. Committee members felt that having a multidisciplinary forum for raising and discussing ethical issues was beneficial, but expressed concern that the committee might usurp or diffuse responsibility for decisions.
A pre-existing moral tradition associated with the institution and an efficient employee leader enhanced the effectiveness of these committees. An orientation program for new committee members and ongoing in-service education on ethical issues are judged important to address membership rotation on the committee and within the institution.