Posts Tagged ‘Diet Ethics Consultation’

Functions of Diet Ethics Committees

Wednesday, February 17th, 2010

There is a paucity of empirical studies of hospital ethics committees. Committees have a “grass-roots” character, reflecting a variety of local circumstances and personalities. These factors make it hard to generalize. Nevertheless, some typical features have emerged. One of these features is interdisciplinary composition. Generally, committees are composed of doctors, nurses, social workers, pastoral-care

professionals, and philosophers or theologians trained in ethics. Committee members can also include administrators, hospital attorneys, and consumer or community representatives. Committees are sometimes authorized by the medical staff; sometimes by the hospital governing board; sometimes by the administration.Committee functions vary but generally include one, two, or all three of the following. First, institutional ethics committees create a vehicle for education on ethical dimensions of patient care. Committees typically have dual efforts in this respect: education of the committee itself, through discussion of current bioethics literature, for example; and education of the medical staff and hospital employees, by organizing periodic lectures, panel discussions, and “ethics grand rounds.”
Second, committees draft institutional policies on hoodia diet ethical questions. This may arise through committee initiative. For example, a hospital panel discussion may reveal the need for a new policy on withholding resuscitation from dying patients, and the ethics committee takes the lead by preparing a first draft. New policies or review of existing policies may also be requested from the ethics committee by the hospital administration, or other hospital committees may route drafts of proposed policies and revisions of existing
policies to the committee for review and comment.

Reasons for Diet Ethics Consultation

Saturday, January 9th, 2010

Diet Ethics consultations are requested for a variety of reasons that include prevention of litigation; mediation of disputes and resolution of conflicts between or among the patient, healthcare professional, and family; confirmation of or challenges to decisions already made; emotional support for difficult decisions; and identification of morally acceptable alternatives.

For example, diet ethics consultation may be requested because physicians and family members disagree about how aggressively to treat a dying, incompetent cancer patient, or because there is difficulty interpreting a patient’s living will.Diet ethics consultants may be called because there is disagreement about the acceptability of a family request to stop tube feeding an Alzheimer patient who refuses to eat. Requests for ethics consultation may come because nurses or house officers are concerned that competent patients are being left out of the decision-making process.

Goals of Diet Ethics Consultation

There is disagreement about the appropriate goals of ethics consultation. John La Puma and E. Rush Priest have suggested that ethics consultations’s primary goal should be “to effect ethical outcomes in particular cases and to teach physicians to construct their own frameworks for ethical decisions making” (La Puma and Priest, p. 17).

Patientrights advocates disagree. They argue that the primary goal of ethics consultation is the promotion of patient autonomy by encouraging shared decision making (Tulsky and Lo). John Fletcher takes a broader view.

He identifies four goals of ethics consultation: (1) to protect and enhance shared decision making in the resolution of ethical problems; (2) to prevent poor outcomes; (3) to increase knowledge of clinical ethics; and (4) to increase knowledge of self and others through participation in resolving conflicts (Fletcher, 1992).