The Workings of an Ethics Committee in the LTC Environment
Jeannine LeCompte, Compliance Research Specialist
An ethics committee devoted to ethical and moral issues relative to resident care should provide a means to ensure and protect the rights of residents.
When creating an ethics committee, take into account the following:
It is highly recommended that the members of an ethics committee include the medical director (or another physician), an administrator, the director of nurses, and the facility’s legal counsel—at the very least. Other members can include clergy representatives, social workers, and community volunteers.
In addition, it may be necessary to co-opt temporary members to provide input on specialized topics. An example of such an ad-hoc member might be a hospice-experienced professional, tasked with supplying expert opinion on matters dealing with end-of-life care.
Topics of discussion for an ethics committee can include end of life conflicts, informed consent, advance directives, the withholding of treatment, and any other medical ethical dilemmas which staff might face.
With regard to the committee’s operational guidelines, the following should be borne in mind:
While there is no legal guideline for ethics committee meetings, logic dictates that they should meet routinely. Frequent meetings will serve to develop ethical policies and procedures and preventative measures which might be taken before a crisis arises.
For this latter purpose, at least one member of the committee should be tasked with researching ethical dilemmas faced by facilities and personnel in the past, and checking to see if their own facility has a policy in place to deal with such an occurrence. For this reason, all ethics committee members will have to be made aware that their attendance at a meeting is compulsory and that notice may be of extremely short duration.
Topic referrals for discussion can also come from other parts of the administration, such as care conferences, the result of QAPI processes, individual requests, or submissions by social workers.
Finally, when an ethical dilemma arises, one of the first documents to be reviewed should be the Minimum Data Set (MDS) of the appropriate resident(s). For this reason, it is important to make sure that the MDS is always accurate and completely up-to-date through completion of a significant change MDS as appropriate.
