Institutional policies vary on whether the ethics committee recommendations on cases referred to them are binding or non-binding on referring clinicians. It is common for the Ethics Committee involvement to be consultative on such cases with their contribution one of deliberation, not decision-making.
The purpose of a hospital ethics consultation is to:
Provide a forum or sounding board for moral reflection on an ethical dilemma or conflict
Not authoritarian; the consultant is not the decision maker
Not purely facilitation; consensus is not the primary goal, but a full understanding of values involved and the range of morally acceptable options
Recognize and resolve, if possible:
The most common responsibilities of ethics committees are to:
Educate the staff and patients about ethical issues
Develop institutional policies
Consult on individual cases referred to them
The Ethics Consultation Meeting often includes the following:
Introduction & Purpose
Case presentation by physician
Identification of ethical conflict and limiting factors
Family brought to table
Determination of patient patient’s preferences and best interests
Discussion (and justification) of possible alternatives and resolutions
There is also great variation among Ethics Committees regarding the following:
Do we keep family there for decision?
Do we keep physicians and health care team there?
Do we vote?
Must all decisions be unanimous?
What do we do with split decision?
Do we keep a record?
Do we enter a note in the chart?