Guidance for Healthcare Ethics Committees

Abstract

This particular book, as indicated by the title, is intended for health care ethics committees (HCECs), which in most instances function in a hospital. The work is divided into four sections and has chapters to support each section's given theme. Small cases are given along with objectives at the beginning of each chapter, which helps give focus and direction to the chapters. There are discussion questions that either help direct a further conversation on the topic or add focus and depth to the chapter. Section one covers the HCEC functions. The four chapters include definition of an HCEC, ethics, ethical theory, and the law related to ethics. Cultural and religious issues are also presented. The fifteen chapters in section two cover the actual consultation. This section is the largest content area of the book and delves into the vital service provided by an ethics consultant or ethics consultation committee. It starts with the mission, vision, and goals of an ethics consultation and progresses on to the consultation process, informed consent, decision-making capacity and its many facets, and the family and the surrogate decision maker. Confidentiality is discussed as it relates to the patient, regulations, and content or timing of disclosure that may have occurred. Medical futility, reproduction, neonatology, and pediatrics ethical issues are also touched on in this section. Section three discusses the ethical world of policy development and organizational issues. The four chapters on this topic present ethics and distributive justice, development of an ethics policy, an ethics policy beyond the hospital in the community, and the place of organizational ethics in the HCEC. The last section is on education, which means education for the committee, for the consultant, and about the pedagogy of ethics. This book has a different author for each chapter. While this may present a wider variety of ideas, it can create a disjointed or uneven flow of content for the reader. As an ethics committee member for several years, I feel that some chapters are very well done. Other areas may cause newcomers to the field to question what their role is or whether they even want to participate in ethics. Ongoing education is vital along with discussion and reflection, which this book provides. A disagreement I have with this book is that several times authors state or imply that the ethics consultant would make recommendations. I have been trained that listening, observing, mediating, and documenting are the parts of an ethics consultation, and that the consultant is the neutral party for all sides. This ethics book differs vastly from Gary Comstock's Research Ethics (Cambridge University Press; 2012; ISBN: 978-0-521-18708-4), also reviewed in this issue of the Journal of the Medical Library Association. The books serve two different foci of the ethics field. I would add both books to my collection for use in education and reference. Both would serve academics or practitioners in their respective areas and, in some cases, would lead to some lively discussion on ethics and research.