Weber L J
University of Detroit Mercy, MI, USA.
Health Prog. 1997 May-Jun;78(3):20-3, 32.
Healthcare ethics committees which have focused almost entirely on clinical ethics, now need to prepare to deal with organizational ethics, a field that is attracting increasing attention. As they did with clinical ethics, ethics committees members must educate themselves in the demands of the newer field. As before, they must respect the perspectives of the actual decision makers while maintaining an independent framework for analyzing the issues at stake. They must ensure that management is properly represented on the committee if they need guidance from a professional ethicist they should seek one with a strong background in business ethics and social justice. Healthcare organizations are likely to need help with a wide range of ethical issues involving patient services (rationing of resources, for example), business and service plans (mergers and joint ventures, for example), business and professional integrity (conflicts of interest, for example), employee rights and responsibilities (downsizing, for example), and the organization's role in in the community (advocacy and lobbying, for example). To be helpful to the organization, the ethics committee must be prepared to say when cost factors trump other considerations and when they do not. An ethics committee will often be asked to give advice on specific occasions-a proposed new policy, for instance. The most important part of its response is its analysis of the issue. Finally, an ethics committee should view its organization as part of the larger social context.
几乎完全专注于临床伦理的医疗保健伦理委员会,现在需要准备好应对组织伦理这一越来越受关注的领域。如同他们处理临床伦理时一样,伦理委员会成员必须了解这一更新领域的要求。和以前一样,他们必须尊重实际决策者的观点,同时保持一个独立的框架来分析所涉问题。如果他们需要专业伦理学家的指导,必须确保管理层在委员会中有适当代表,并且应寻找一位具有强大商业伦理和社会正义背景的伦理学家。医疗保健组织可能需要在广泛的伦理问题上获得帮助,这些问题涉及患者服务(例如资源分配)、商业和服务计划(例如合并和合资企业)、商业和职业诚信(例如利益冲突)、员工权利和责任(例如下岗)以及组织在社区中的角色(例如倡导和游说)。为了对组织有所帮助,伦理委员会必须准备好在成本因素何时胜过其他考虑因素以及何时并非如此的问题上表明立场。伦理委员会经常会被要求在特定场合提供建议——例如一项拟议的新政策。其回应中最重要的部分是对问题的分析。最后,伦理委员会应将其所在组织视为更大社会背景的一部分。