When clinical ethicists are called upon to give a recommendation regarding patient care, they may be faced with a dilemma of their own. If their own personal opinion is not widely shared, the ethicist will have three options. These include: (1) giving their own opinion; (2) giving the widely shared opinion; and (3) giving both opinions, leaving the physician to select which opinion to accept. The intentions of this article are to evaluate strengths and weaknesses of these three alternatives and (...) to suggest that ethics consultants recognize and deal with this issue. Two cases are presented to explore the limitations of each option. The author suggests that when the views of ethics consultants differ from the consensus view, the consultant should give the consensus view, their own dissenting view and the arguments in support of each position. (shrink)

The present trend toward routine inquiry appears to be based on the false premise that the individual's wishes cannot be known and that, therefore, the family is the only alternative for making donation decisions. The UAGA states that the family should be turned to only when the wishes of the individual are not known.To protect the right of individuals to make their own decision, an effective and efficient process for making the wishes of individuals known should be devised and the (...) UAGA amended accordingly. I have presented the policy of strong required request as the best way to effectively protect the rights that the UAGA ostensibly gives to the individual. This policy ensures that the individual's wishes, both for and against donation, are known. It also alleviates some of the problems in the original approach that hindered the procurement of organs from willing donors. Strong required request saves families from making critical decisions, which may be painful and conflicted for some, at a time of emotional shock and grief. (shrink)

Over the past 15 years, ethics committees have become common within the acute care hospital setting. Their development within long-term care settings has evolved more slowly and has been confined primarily to nursing homes. In this paper, I describe the development of an ethics committee in a residential center for the mentally retarded and developmentally disabled. I describe how the committee has progressed and some of the ethical issues in this setting.