Ethics Committees Flashcards
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
What were the baby doe rules?
Establishment of 1-800 numbers to address ethical concerns in the NICU
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
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
True or false: well functioning ethics committees should have an educational plan for themselves and others
True
True or false: well functioning ethics committees are about developing an advocacy model
False
True or false: well functioning ethics committees are about having ethics experts
False
True or false: well functioning ethics committees utilizes a good record keeping system
True
True or false: well functioning ethics committees commits to regular self evaluations, and meet regularly
True
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
True or false: well functioning ethics committees are a forum for discussion, but not advice
True
True or false: well functioning ethics committees make clinical decisions
False
What is the role of ethics committees in ethical cases?
Mediation–resource for discussion, not a determining body
What are the three competencies for health care ethics consultation?
- Ethical assessment skills
- Process skills
- Interpersonal skills
What is the most common underlying issue that comes to ethics committees?
Communication issues (90%)
What percent of questions that ethical committees have an actual ethical issue underlying them?
5%
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
What are the downsides of having an ethics consultant as opposed to a committee?
- one view
- Reliance on that person
What are the negatives of an ethics subcommittee?
- organization
- May lack sufficient expertise
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
