Health care ethics consultation in the United States

Abstract

HCEC services perform a distinct role in modern health care institutions. Fundamentally, their roles are to (1) clarify ethical values and aid in conflict resolution, (2) provide ethics education, and (3) make and review institutional policy. As with IRBs, the guiding framework for ethics committees is constituted by the principles of medical ethics, which were first described in the Belmont Report as respect for persons, beneficence, and justice [9]. The function of ethics committees extends beyond that of IRBs, which are principally concerned with research ethics and compliance with federal regulations. While palliative care services deal with medical and goals-of-care issues at the end of life, HCECs are called upon to identify, analyze, and help in the resolution of ethical conflicts in cases involving patients at all stages of life. Some institutions find it useful to have separate pediatric and adult ethics committees because of the unique issues arising with these different patient populations. Our goal in this issue is to articulate for the reader some of the current issues regarding HCECs, with the hope that improved understanding of HCECs will lead to more effective and appropriate use of their services in clinical care.