β Scribed by Mary B. Mahowald
No coin nor oath required. For personal study only.
Hospital ethics committees (HECs), particularly those that address issues regarding treatment (or non-treatment)of disabled newborns, have proliferated during the last few years. In 1981, only one per cent of hospitals in the United States had HECs (1,2). In 1984 a national survey disclosed that a majority of institutions caring for infants had HECs (3). Government interventions in provocative cases such as those of the "Doe ~ babies (Bloomington, 1982, and Stoney Brook, 1983), and government recommendation of hospital committee review have probably precipitated this development (4-6). Many have viewed this mechanism as preferable to, and instrumental in avoiding, unpleasant and costly legal and judicial disputes.
An adjunct of this development has been the recruitment of philosopher-ethicists to serve on hospital ethics committees. As one who has been closely involved with ethical issues in the clinical situation for the last seven years (my office is on the main floor of a major university hospital complex), I have observed, initiated, and participated in the development and/or activities of a number of HECs. The first was organized in 1977 for University Hospitals of Cleveland and was reported on by Youngner et aL in 1984 (7). The second is an extension of this committee to pediatric patients, a committee for Rainbow Babies and Childrens Hospital.
A third is established specifically for MacDonald Hospital for Women. Fourth and fifth are an infant review committee, and a general ethics review committee for Cleveland Metropolitan General Hospital. A sixth has been formed at the Veterans' Administration Hospital that is affiliated, as are all of the preceding institutions, with the School of Medicine at Case Western Reserve University.
π SIMILAR VOLUMES
HECs, also IECs) emerged in response to a number of seemingly unrelated concerns. Among these were advances in medical technology, a corresponding increase in opportunities for legal liability, and a concern to control situations laden with liability, such as those arising out of "Baby Doe" Regulati