Hospital Ethics Committees (HEC) have a relatively short history. Yet, there is already a modicum of uniformity in the activities that these committees perform. One of the earliest proposals for the formation of HECs was the 1971 Medico-Moral Guide of the Canadian bishops.
The tasks outlined for the proposed medical-moral committees in Catholic hospitals were to: (a) assume responsibility for educating the total hospital community concerning the developing medical-moral trends in effective health care; (b) provide a forum for interdisciplinary dialogue; (c) provide a basis for unified direction and interpretation of the Ethical and Religious Directives for Catholic Health Care Facilities, published in 1971 by the U.S. Conference of Catholic Bishops; (d) serve as a channel of communication "from the front line of experience to the rear line of policy making"; and (e) serve as a legislative watchdog (1, p. 269).
Soon thereafter, in 1973, the Massachusetts General Hospital Critical Care Committee created a multidisciplinary ad hoe subcommittee to study and to recommend treatment both for the hopelessly ill patient as well as the appropriate utilization of limited critical care facilities (1).
In 1977, Montefiore Medical Center in New York City formed a bioethics committee. Its purpose was to serve as an educational, policy-making, and guideline-writing body. However, the committee was not seen as being very successful by its leadership (1).
After the Quinlan decision there was a significant increase in the prevalence of institutional ethics committees (IEC). Recently, there have been some attempts to legislate the functions of HECs. In Maryland's statute, the Patient Care Advisory Committee is required to be "involved in cases involving life-threatening conditions" (2,. But the remainder of the legislative charge to these committees is broad, and includes "medical decision-making" and "withholding of