Ethics Committees Flashcards by tcarlso 3

What were the three reasons that prompted the development of ethics committees from Karen Teel, MD?

Physicians had:

responsibility and risk
Were ill equipped to make hard decision
Assumed civil and criminal liability

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What were the baby doe rules?

Establishment of 1-800 numbers to address ethical concerns in the NICU

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What are the roles of ethics committees? (6)

create a forum for discussion
Provide education for professionals
Create educational programs
Provide consultation for case management
Review/develop hospital policy
Serve as a catalyst for organizational ethics

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What are the four goals of ethics committees?

Promote the rights of patients
Promote shared decision making b/t pts and clinicians
Promote fair policies and procedures
Enhance ethical tenor in health care

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True or false: well functioning ethics committees should have an educational plan for themselves and others

True

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True or false: well functioning ethics committees are about developing an advocacy model

False

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True or false: well functioning ethics committees are about having ethics experts

False

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True or false: well functioning ethics committees utilizes a good record keeping system

True

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True or false: well functioning ethics committees commits to regular self evaluations, and meet regularly

True

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Who usually comprises ethics committees? (6)

People who represent major clinical services
One person who has advanced ethics education
Quality improvement manager
Rep from edu dept
Community rep
Lawyer

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True or false: well functioning ethics committees are a forum for discussion, but not advice

True

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True or false: well functioning ethics committees make clinical decisions

False

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What is the role of ethics committees in ethical cases?

Mediation–resource for discussion, not a determining body

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What are the three competencies for health care ethics consultation?

Ethical assessment skills
Process skills
Interpersonal skills

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What is the most common underlying issue that comes to ethics committees?

Communication issues (90%)

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What percent of questions that ethical committees have an actual ethical issue underlying them?

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What is an ethics consultant?

an expert in clinical ethics who provides either ethics consultation services or serves as an educational consultant to the ethics committee

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What are the downsides of having an ethics consultant as opposed to a committee?

one view

- Reliance on that person

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What are the negatives of an ethics subcommittee?

organization

- May lack sufficient expertise

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Who can order an ethics consult?

Anyone–pts, family member, or any member of health care team

True or false: it is appropriate to consult an ethics committee on a non-active pt case

True

What has been the progression of issues presented to ethics committees?

From moral dilemmas to moral distress/dissonance

What is a moral dilemma?

A situation involving choices between equally (un)satisfactory alternatives

What is moral distress?

Painful feelings or psychological disequilibrium caused by a situation where there are some sort of social/institutional barriers

What is moral dissonance?

Inconsistency between the beliefs and values of the parties to the decision making process

What are the environmental factors that can cause moral distress? (4)

- inadequacy of resources - Communication milieu/lack of privacy - Pressure of time - Techno-rational chaos

What are the three intrapersonal elements that often lead to moral distress?

- moral distress - Sense of powerlessness - Sense of fear

What are the consequences of unattended moral distress?

- Moral outrage | - Burnout/Quitting

What are the five measures to reduce moral distress?

- Communication of moral values - Involvement in decision making - Peer support - Values education/ethics forum - Interdisciplinary communication

What was the first state to require ethics committees by law?

Maryland

What was the organizing body that established a mechanism for hospital personnel to consider and educate its constituents on ethical issues?

The Joint Commission for the accreditation of healthcare organizations (JACHO)

What type of skill (ethical assessment, process, or interpersonal skills) is exemplified by: Discerning and gathering relevant data

Assessment

What type of skill (ethical assessment, process, or interpersonal skills) is exemplified by: Assessing the social and interpersonal dynamics

Assessment

What type of skill (ethical assessment, process, or interpersonal skills) is exemplified by: distinguishing the ethical dimensions of the case from other, often overlapping dimensions

Assessment

What type of skill (ethical assessment, process, or interpersonal skills) is exemplified by: Identifies various assumptions

Assessment

What type of skill (ethical assessment, process, or interpersonal skills) is exemplified by: Identifies relevant values of involved parties

Assessment

What type of skill (ethical assessment, process, or interpersonal skills) is exemplified by: Identifying key decision makers

Process

What type of skill (ethical assessment, process, or interpersonal skills) is exemplified by: setting ground rules for formal meetings

Process

What type of skill (ethical assessment, process, or interpersonal skills) is exemplified by: express and stay within limits of the role of ethics consultation

Process

What type of skill (ethical assessment, process, or interpersonal skills) is exemplified by: Create an atmosphere of trust that respects privacy and confidentiality

Process

What type of skill (ethical assessment, process, or interpersonal skills) is exemplified by: Listens well and communicates interest, respect, support, and empathy

Interpersonal

What type of skill (ethical assessment, process, or interpersonal skills) is exemplified by: Educate involved parties

Interpersonal

What type of skill (ethical assessment, process, or interpersonal skills) is exemplified by: Eliciting the moral views of involved parties

Interpersonal

What type of skill (ethical assessment, process, or interpersonal skills) is exemplified by: Represents the views of involved parties to others

Interpersonal

What type of skill (ethical assessment, process, or interpersonal skills) is exemplified by: Enable involved parties to communicate effectively, and be heard by others

Interpersonal

What type of skill (ethical assessment, process, or interpersonal skills) is exemplified by: Recognize and attend to relational barriers to communication

Interpersonal

What is meant by the term preventative ethics?

Establishing systems and processes to resolve or identify ethical dilemmas

What is meant by the term ethics leadership?

Creating an environment and culture that is conducive to solving ethical dilemmas