Summary
This survey describes in detail ethics committees (ECs) at acute care hospitals in Upstate New York. It finds that in just two years (1984 and 1985), following the Baby Doe controversy and the Report of the President’s Commission, 40% of urban ECs and 37% of university ECs were formed. One half of rural ECs formed in 1992–1995, following the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requirement of access to ethics consultation. Generally, ECs are committees of the powerful within the hospital; the administration or the medical staff is the organizational parent of 73% of ECs. These groups appoint 80% of EC chairs and 79% of members; they constitute 45% of the membership. Most EC members (81%) lack even rudimentary formal training in bioethics, yet only 18% of ECs consider member education a major role. Many ECs are rather inactive: 53% meet less than every other month and 61% have fewer than six case consultations in the prior year. On the basis of this survey’s findings, suggestions are offered to improve the credibility of these ubiquitous committees as stewards of bioethics, rather than of the powerful within the hospital.
Similar content being viewed by others
References
Agich, G.J. & Youngner, S.J. (1991). For experts only? access to hospital ethics committees. Hastings Center Report, September-October, 17-25.
Ahronheim, J.C., Moreno, J., Zuckerman, C. (1994). Ethics in clinical practice. Boston, MA: Little, Brown and Company.
Backlar P. McFarland B.H. (1994). Ethics committees in state mental hospitals: A national survey. Hospital and Community Psychiatry 45(6): 576-580
Brennan T.A. (1988). Ethics committees and decisions to limit care. The Journal of the American Medical Association 260(6): 803-807
Callahan D. (1992). Ethics committees and social issues: potentials and pitfalls. Cambridge Quarterly of Healthcare Ethics 1, 5-10
Carter, B.S. (1988). Medical ethics committee-A survey of army hospitals. Military Medicine, 153(8), 426-429.
Chambliss, D.F. (1996). Beyond caring: hospitals, nurses, and the social organization of ethics. Chicago, IL: The University of Chicago Press.
Childress, J. (1970). Who shall live when not all can live? Soundings, 53, 339-355.
Cranford, R.E. & Jackson, D.L. (1984). Neurologists and the hospital ethics committee. Seminars In Neurology, 4(1): 15-22.
Cranford, R.E. & Van Allen, E.J. (1985). The implications and applications of institutional ethics committees. American College of Surgeons Bulletin, 70(6), 19-24.
Curran, C.E. (1978). Roman Catholicism. In: WT Reich (ed.). Encyclopedia of Bioethics, Vol.4. New York, NY: Free Press, pp.1522-1534.
De Ville, K. & Hassler, G. (2001). Healthcare ethics committees and the law: uneasy but inevitable bedfellows. HEC Forum, 13(1), 13-31.
Fleetwood, J. & Unger, S.S. (1994). Institutional ethics committees and the shield of immunity. Annals of Internal Medicine, 120(4), 320-325.
Fletcher, J.C. & Hoffmann, D.E. (1994). Ethics committees: time to experiment with standards. Annals of Internal Medicine, 120(4), 335-338.
Fletcher, J.C. & Spencer, E.M. (1997). Ethics services in healthcare organizations. In: J.C. Fletcher, P.A. Lombardo, M.F. Marshall, et al. (eds.). Introduction to clinical ethics, Second edition. Hagerstown, MD: University Publishing Group, Inc., pp. 263-264.
Gramelspacher, G.P. (1991). Institutional ethics committees and case consultation: is there a role? Issues in Law & Medicine, 7(1), 73-82.
Hoffmann, D.E. (1991). Does legislating hospital ethics committees make a difference? A study of hospital ethics committees in Maryland, the District of Columbia, and Virginia. Law, Medicine & Health Care, 19(1- 2), 105-119.
Hoffmann, D.E. (1993). Evaluating ethics committees: a view from the outside. The Milbank Quarterly, 71(4), 677-701.
Hosford, B. (1986). Bioethics committees: the health care provider’s guide. Rockville, MD: Royal Tunbridge Wells, pp. 127-128.
Joint Commission on Accreditation of Healthcare Organizations (JCAHO) (1991). Accreditation manual for hospitals. Oakbrook Terrace, IL: Joint Commission for Accreditation of Healthcare Organizations; Section RI.1.1.6.1.
Lappetito, J. & Thompson, P. (1993). Today’s ethics committees face varied issues. Health Progress, November, 34-39 and 52.
Levine-Ariff, J. (1989). Institutional ethics committees: a survey of children’s hospitals. Issues in Comprehensive Pediatric Nursing, 12(6), 447-461.
Lo, B. (1987). Behind closed doors: promises and pitfalls of ethics committees. The New England Journal of Medicine, 317(1), 46-50.
Martino, F. & Peto, R. (eds.) (2001). Medical directory of New York state, Vol. LXVII. Lake Success, NY: Medical Society of the State of New York.
Mason, D.J., Johansson, E., Fleming, C., et al. (1989). Ethics committees in health care institutions in the New York City metropolitan region: a report of two nursing surveys. Journal of the New York State Nurses Association, 20(4), 13-16.
McGee, G., Spanogle, J.P., Caplan, A.L., et al. (2002). Successes and failures of hospital ethics committees: A national survey of ethics committee chairs. Cambridge Quarterly of Healthcare Ethics, 11(1), 87- 93.
Nelson, R.M., Botkin, J.R., Kodish, E.D., et al. (2001). Institutional ethics committees. Pediatrics, 107(1), 205-209.
Povar, G.J. (1991). Evaluating ethics committees: what do we mean by success? Maryland Law Review, 50, 904-919.
Rosner, F. (1985). Hospital medical ethics committees: a review of their development. The Journal of the American Medical Association, 253(18), 2693-2697.
Ross, J.W., Glaser, J.W., Rasinski-Gregory, D., et al. (1993). Health care ethics committees: the next generation. Chicago, IL: American Hospital Publishing, Inc.
Scheirton, L.S. (1992). Determinants of hospital ethics committee success. HEC Forum, 4(6), 342-359.
Smith, M.L. & Burleigh, D. (1991). Pastoral care representation on the hospital ethics committee. HEC Forum, 3(5), 269-276.
Swenson, M.D. & Miller, R.B. (1992). Ethics case review in health care institutions: committees, consultants, or teams? Archives of Internal Medicine, 152(April), 694-697.
Traenin, I.N. & Rosner, F. (1978). Jewish codes and guidelines. In: WT Reich (ed). Encyclopedia of Bioethics, Vol.4. New York, NY: Free Press, pp. 1428-1431.
Wilson R.F. (1998). Hospital ethics committees as the forum of last resort: an idea whose time has not come. North Carolina Law Review 76: 353- 406
Wolf S.M. (1991). Ethics committees and due process: nesting rights in a community of caring. Maryland Law Review 50, 798-888
Youngner S.J., Jackson D.L., Coulton C et al. (1983). A national survey of hospital ethics committees. Critical Care Medicine 11(11): 902-905
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Milmore, D. Hospital Ethics Committees: A Survey in Upstate New York. HEC Forum 18, 222–244 (2006). https://doi.org/10.1007/s10730-006-9009-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10730-006-9009-y