Today, I attended a conference in Memphis conducted by Micah Hester, who just published a new book titled Ethics by Committee: A Textbook on Consultation, Organization, and Education for Hospital Ethics Committees.The session was well-planned and focused largely on how to conduct consults. But it also covered a little of ethics committees bylaws, education, and policy drafting. Books like this and education seminars like this are important. Yet, they are sorely underutilized. While most of the nearly 6000 hospitals in the United States must (per Joint Commission accreditation requirements) have a mechanism to resolve ethics issues, most are sloppily constituted and most (and sometimes all) members lack any training in either substantive bioethics or conflict resolution.
The constitution and qualifications of hospital ethics committees materially matters to medical futility because most consults of most ethics committees concern end-of-life disputes. And futility disputes comprise a large proportion of these. Since treatment disputes are almost always resolved extra-judicially, the ethics committee is often the de facto (and in sometimes even the de jure) forum of last resort.
I truly appreciate Thaddeus's kind comments about the seminar, but I'm even more excited by his call for better education for HEC members. Whatever modes used (textbooks, one-day seminars, monthly readings and discussion, etc.), the point is to provide members with a firmer grounding for the ethical reflections they are asked to make--whether those reflections be about patient care or institutional policies. I echo his call for committees to commit to some regular and robust educational process.
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