โ Scribed by Paulette Sansone
No coin nor oath required. For personal study only.
Nursing homes today face many ethical challenges and dilemmas, yet the majority of these institutions do not have viable and active ethics committees to assist and guide professional staff, residents, and families with difficult and complex decisionmaking. Surveys have shown that only 2%-27% of nursing homes have healthcare ethics committees (HECs), compared with 50% of the nation's hospitals (1)(2). In a 1994 telephone survey of 129 long-term care facilities in New York City (3), 46 were found to have ethics committees and among these some were Ad Hoc or non-functioning committees. Even though this number is fairly consistent with the literature, it is still surprising given the range, magnitude, and uniqueness of ethical issues facing long-term care facilities today. There may come a time when nursing homes will not have a choice, and will be mandated to establish HECs. This time may soon come in New York State should the proposed Family Health Care Decisions Act be passed by the Legislature.
Traditionally, HECs have served an advisory role, the main functions being three-fold (4):
.
Education: the education of nursing home staff, residents, families, and the community at large.
. Case Review and Analysis: reviewing and examining individual situations and cases, asking necessary and appropriate questions, and making recommendations.
. Policy Development: Drafting policies and procedures having to do with ethics and ethical decisionmaking, e.g. DNR policy and policy concerning the freedom of the residents.
๐ SIMILAR VOLUMES
Institutional ethics committees (1ECs) in health care facilities now create moral policy, provide moral education, and consult with physicians and other health care workers. After sketching reasons for the development of 1ECs, this paper first examines the predominant moral standards it is often as
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