Academic journal article The Hastings Center Report

The Social Transformation of Some American Ethics Committees

Academic journal article The Hastings Center Report

The Social Transformation of Some American Ethics Committees

Article excerpt

A hospital is not a hotel. The institution must do more than provide rooms in which patients reside and physicians work. It must also take responsibility for who uses its rooms and what goes on within them, a court ruled in the mid-60s [Darling v. Charlatown Community Memnorial Hospital, 33 111. 2d 326, 211 N.E. 2d 253 (1965)]. This decision was part of the challenge to physician control of medical practice that Paul Starr has termed "the social transformation of American medicine." As our authors below indicate, either directly or indirectly, the trend toward institutions'control of health care delivered within their walls is now encompassing ethics committees as well.

The fates of institutional ethics committees and physicians have been closely linked. Each has a primary moral commitment to protect patient well-being. For this reason, ethics committees of the mid-70s were the creatures of physicians who initiated them to gain intra- and interdisciplinary advice about ethical use of innovative technologies for patient care. Changes in the institutional role of physicians, therefore, mean changes in the role of ethics committees.

Medical care in the 80s has increasingly been subjected to the scrutiny of professional managers interested in advancing their institution's share of the market in a highly competitive industry. Ethics committees are also experiencing new pressures to safeguard the institution's financial interests. …

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