The document outlines the role and responsibilities of hospital ethics committees in addressing ethical issues in patient care, emphasizing patient participation and education. It discusses various bioethics topics like end-of-life decisions, informed consent, and allocation of resources, as well as the historical development of ethical standards in healthcare. Additionally, it underscores the importance of principles such as patient dignity, confidentiality, and the ethical obligations of healthcare providers.

1. HOSPITAL ETHICS
COMMITTEES
Bioethics Mahboob Ali Khan
MHA,CPHQ

2. Mission
Hospital Ethics Committee
To create a mechanism to allow the patient or the patient’s
designated representative to participate in the
consideration of ethical issues that arise in the care of
the patient; to provide an organization and mechanism
for the consideration of ethical issues arising in the care
of patients; and to provide education to care givers and
patients on ethical issues in health care.

3. Bioethics Issues:
Past and Present
• Defining Death
• Foregoing/Withdrawing
Treatment
• Permanently Unconscious
Patients
• Withholding Food and
Fluids
• In Vitro Fertilization
• Surrogate Parenting
• Fetal Tissue Research
• Euthanasia, Active and
Passive
• Abortion
• Genetic Engineering
• Assisted Suicide
• Organ Transplantation
• Do Not Resuscitate
Orders
• Informed Consent
• Access to Care/Indigent
Care
• Allocation of Scarce
Resources
• Cloning

4. Brief History of the Bioethics Movement
• 1962 Kidney Dialysis --”Patient Selection Committees”
• 1968 Definition of Irreversible Come (Brain Death) by
ad hoc Committee of Harvard Medical School
• 1976 Karen Ann Quinlan --Prognosis Committees”
• 1980-83 President’s Commission for the Study of
Ethical Problems in Medicine and
Biomedical and Behavioral Research
• Early 80’s Ethics Committees Emerging:
1981 Less than 1% of Hospitals
1985 50% of Hospitals
Today 75% of Hospitals
• 1982 Baby Doe Care (esophageal atresia)
• 1989 Nancy Cruzan – right to die; removal of feeding tube

5. Joint Commission on Accreditation of
Health Care Organizations
Standard: “Patient Rights and Organizational Ethics”
• Promote consideration of patient values and preferences
including decision to continue treatment
• Recognize hospital’s responsibilities under the law
• Inform patients of their responsibilities in the care process.
• Manage the hospital’s relationships with patients and the
public in an ethical manner.

6. Hospital Ethics Committee
Membership
Profile:
7 Physicians
1 Dentist
6 Nurses
1 Social Worker
1 Philosopher
1 Clergywoman
2 Attorneys
1 Hospital Administrator
20

7. Responsibilities of
Hospital Ethics Committee
• Education - facilitate educational opportunities for health
care professionals, patients, and their families.
• Consultation - provide consultative services regarding
ethical issues pertaining to a specific patient.
• Policies and Procedures - discussion and evaluation of
policies and procedures having ethical implications.

8. Education

9. Principles of Patient Care
• Each patient shall be treated as a whole,
irreplaceable, unique and worthy person.
• The patient’s safety, health, or welfare shall be
protected and shall not be subordinated to
organizational, staff, educational, or research
interests or to any other end.

10. Principles of Patient Care (cont.)
• Behavior reflecting the dignity, responsibility and
service orientation of health care professions worthy
of the public’s respect and confidence, shall be
practiced by all individuals.
• Each patient shall have a responsible attending
physician or dentist.

11. Principles of Patient Care (cont.)
• The privacy of the patient and the confidentiality of
every case and record shall be maintained.
• Patients and/or responsible family shall be informed
at all stages of care about personnel responsible for
the patient care, treatment plans, and activities for
the patient, facilities and services available to the
patient, and responsibilities of the patient and family.

12. Informed Consent
Respect for
Autonomy
Beneficence

13. Consultation

14. Policies and Procedures

15. Withholding/Withdrawing
Potentially Life Sustaining
Treatment
-- Hospital Policy --

16. Levels of Support
(Do not resuscitate orders)
Level 1 Full support, including CPR
Level 2 Full support, excluding CPR
(DNR)
Level 3 Modified support, excluding
CPR (DNR)
May include: ventilation,
entral feeding, dialysis,
antibiotics, etc.

17. Guidelines on Pain Control for
the Dying Patient

18. Resource Materials for a
Establishing A Hospital Ethics
Committee

20. Our Committee Can Present
Programs On:
• Basic Principles of Bioethics
• Withholding/Withdrawing Policies
• Futile Treatment
• Informed Consent
• Managed Care Ethics
• Consultation Competencies
and with adequate notice and time to prepare,
other topics of interest in bioethics.