Healthcare Ethics Community Discussions Responses

125 each with at least 1reference

One: An ethics committee is designed to provide assistance and guidance in addressing ethical issues that develop in patient care. The committee should help drive decision-making that respects participants’ values, concerns, and interests (AMA, 2020). The committee is typically comprised of a multidisciplinary team. In a hospital setting, this would include doctors, nurses, social workers, administrators, chaplains, and other employees (URMC, 2020). A diverse group provides a broad spectrum of expertise and opinion, helping to ensure all factors are considered and stakeholders represented.

While it is easy to understand why providers, healthcare professionals, and administrators are included on the committee, and the argument can be made that each of these roles has a duty to patient advocacy, they each also have other vested interests. Other vested interests can include/involve such things as union contracts and the profitability of the hospital – which can conflict with the best interests of the patient. Because of this scenario, it is important to include at least one member of the committee that represents the patient – without other (potentially conflicting) interests.

Having a committee member that solely represents the interests of the patient is recommended. This ensures a well-rounded panel in which all parties and interests are represented. I believe it also keeps the discussion patient-centered, as discussion/debate can easily be shifted to other areas of impact and at the core of all healthcare must be the patient. While no one voice should carry more weight than the others, it is imperative that all voices – including a representative of the patient – be included.

Some ethics committees do include outside community members (or guests) as well – and often include members with expertise and experience in the law or theology (UW, 2020). It is important to create a group that is large enough to be diverse but not so large that decisions cannot be agreed upon. Community members that are included should have some area of experience or expertise that brings value to the discussions and the group.

References
AMA. (2020). Ethics Committees in Health Care Institutions. AMA. Retrieved from https://www.ama-assn.org/delivering-care/ethics/ethics-committees-health-care-institutions#:~:text=Ethics%20committees%2C%20or%20similar%20institutional,values%2C%20concerns%2C%20and%20interests.&text=(a)%20Serve%20as%20advisors%20and%20educators%20rather%20than%20decision%20makers.

URMC. (2020). Ethics Consultation. URMC. Retrieved from https://www.urmc.rochester.edu/highland/patients-visitors/hospital-services/ethics-consultation.aspx#:~:text=The%20Ethics%20Committee%20is%20a,Committee%20has%20three%20main%20purposes.

UW. (2020). Ethics Committees and Consultation. UW Medicine. Retrieved from http://depts.washington.edu/bhdept/ethics-medicine…

Two: With the vast amount of possible ethical problems that can arise in the healthcare setting, it would be prudent to have knowledgeable persons from various backgrounds that can contribute to the decision and policy making performed by healthcare ethics committees. Morrison & Furlong (2019) discuss the importance of having patient advocates or community members on the healthcare ethics committee. They state, “The importance of considering the patient in making ethics decisions requires a member or members who understand the patient’s view of the situation” (p. 112). Many healthcare organizations choose to have social workers on their healthcare ethics committee to have the patient’s point of view. Allen (2020) discusses how social workers can be instrumental in resolving complex ethical cases in a variety of settings such as hospitals, nursing homes, and home care agencies. She states, “The extensive training social work students receive in social work values and ethics in accredited programs prepare us to make valuable contributions to our organizations and clients when ethical dilemmas arise…and the strength and clarity of the NASW Code of Ethics provide an important framework for helping determine the best course of action in these situations” (para. 12). She discusses how a social worker’s knowledge of the patient’s family and support system help inform ethic committees who should be included in the process, as well as how a social worker’s assessment skills are useful in determining if the patient or family is capable of fully understanding the issues and whether they should participate in the decision making. Social workers also have an understanding of social justice issues that can provide insight and guidance to ethics committees in cases involving poor and underinsured patients, and be an active voice to prevent discrimination against minorities and the poor.

As for other types of community members being included on healthcare ethics committees, Geppert & Shelton (2016) advocate for diversity in membership. They state for mediation to be effective and balanced, “Healthcare ethics committees’ membership needs to be representative of not only the health care community, but also patient populations – both those who serve and those who are served” (p. 536). They argue for the inclusion of community members who are chaplains, social workers, attorneys who can provide an ethical perspective in relation to law, and administrators who are proficient in policy development. Morrison and Furlong (2019) explain that because the ethics board represents the community it is important that members on the committee be knowledgeable about the larger community’s concerns regarding the demographic area that the hospital serves. Having a community representative who understands the impact that decisions can have on the community can be a beneficial voice on a healthcare ethics committee.

Allen, K.N. (2020). Health care social workers and ethics committees. Retrieved from https://www.socialworker.com/feature-articles/ethics-articles/Health_Care_Social_Workers_and_Ethics_Committees/.

Geppert, C.M.A., & Shelton, W. (2016). Health care ethics committees as mediators of social values and the culture of medicine. AMA Journal of Ethics, 18(5), 534-539. Retrieved from https://journalofethics.ama-assn.org/sites/journalofethics.ama-assn.org/files/2018-05/msoc1-1605.pdf.

Morrison, E.E. & Furlong, B. (2019). Health care ethics: Critical issues for the 21^st century. 4^th ed. Burlington, MA. Jones and Bartlett Publishers.