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A new Joumal, HEC Forum, which focuses on ethical and legal issues that institutional ethics committees face, is designed to serve as a practical resource for ethics committees, rather than a scholarly academic journal. To this end, its authors are members of ethics committees. Thus far, it has featured articles on such issues as how to publicize an ethics committee within an institution, ways in which mulfi-institutional ethics committees can function, how committees can educate medical staff, and what sort of legal protection institutions should afford ethics committees. The journal is published six times a year by Pergamom Press, Maxwell House, Fairview Park, Elmsford, New York 10523.

In Protocols for Elective Use of Life-sustaining Treatments: A Design Guide (New York: Springer, 1989), Steven H. Miles and Carlos F. Gomez have developed a useful resource for institutional ethics committees engaged in policy development They consider the nature and objectives of protocols for the use of life-sustaining treatments, how to design and implement them, and ways in which they might be applied to specific clinical situations. Ethics committees will find the extensive references and appendices with sample policies in this book especially helpful.

A survey of hospitals having a formal policy regarding advance directives reveals no positive correlation between the existence of ethics committees and the formulation of such policies, S. Van McCrary and Jeffrey P- Botkin report in "Hospital Policy on Advance Directives: Do Institutions Ask Patients about Living Wills?" Journal of the, American Medical Association 262:17 (1989), 2411-14. Moreover, only 43% of existing policies had been reviewed by an ethics committee in hospitals that had such committees and policies. This study suggests that many ethics committees are not actively participating in hospital policy formulation on this issue.

Ethics committees and ethics consultants have different functions and identifies, John La Puma and Stephen E. Toulmin maintain in "Ethics Consultants and Ethics Committees" Archives of Internal Medicine 149:5 (1989), 109-112. Ethics committees, they argue, are too distant from the bedside to assist in patient care and should instead function as administrative bodies that formulate institutional policy, educate hospital staff, and provide a forum for interdisciplinary discussion of ethical issues. Ethics consultants who are clinicians-persons who understand a patient's medical condition and take pan in "managing" their care-should perform ethics consultations, for their knowledge of individual patients and common medical conditions enables them to clarify clinical ethical questions and contribute to effective patient care.
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Title Annotation:ethics committees
Publication:The Hastings Center Report
Date:Mar 1, 1990
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