Q&A: The role of an ethics committee within a health system

Q: What kinds of things should the ethics committee at my health system be reviewing?

A: Despite the presence of clear guidelines for ethics committees, these working groups vary considerably across institutions. There are varying perceptions of the right composition and number of members, their amount of preparation, the scope of each member’s role, and the quality of the work expected. It is common to see ethics committees developed without any formal plan, which can easily lead to unfilled expectations, inactivity, and a perception by the organization that the committee is not a valued resource (McCabe, 2015).

One large misperception of ethics committees lies in their function. Contrary to popular belief, ethics committees are not in place to tell clients, caregivers, or colleagues what to do. The traditional role of an ethics committee was to explore the clinical nuances of a particular situation and make sure the wishes of the patient were acknowledged specific to end-of-life decisions, while recognizing their right to refuse care, treatment, and services in accordance with all laws and regulations. In recent years, ethics committees affiliated with academic institutions and large healthcare systems have expanded their traditional functions to become more comprehensive ethics programs. There has been considerable expansion of how ethics committees are viewed, at times providing consultations in response to nonclinical ethics questions, identifying and remedying systems-level factors that induce or exacerbate ethical problems and/or impede their resolution, and promoting a positive ethics culture throughout the institution. A number of organizations now use the terminology "integrating ethics throughout the healthcare institution from the bedside to the boardroom" (University of Washington, 2013). The basic functions and goals of ethics committees appear below:

Consultation

• Ensure training and support for committee members and consultants
• Provide consistent subject matter expertise for case requiring formal ethics evaluation and recommendations
• Develop and implement evaluation metrics to ensure quality improvement
• Develop appropriate reports, publications, and presentations for both internal personnel and external strategic partners

Education

• Ensure knowledgeable ethics committee members
• Provide appropriate education to the organization (e.g., trainings, journal articles, reports, available literature on professional resource trainings and conferences)

Policy review and development

• Work with organization’s leadership to ensure ethics input in relevant situations that impact patient care
• Ensure development of appropriate policies

For more information, see The Essential Guide to Interprofessional Ethics in Healthcare Case Management . Need expert advice? Email your questions for consideration in the Revenue Cycle Daily Advisor. Note: We do not guarantee that all questions will be answered.