Governing boards as facilities' principal ethics committees.

Ethics is the systematic analysis of our (individual and organizational) behavior's impact on the dignity of persons. It is the disciplined approach to choosing the better alternative for respecting dignity. Any group that primarily deals with issues that have a deep and broad impact on the dignity of persons should be recognized as an ethics committee. In organizations such as hospitals, the chief among these groups is the board of trustees because governance responsibility concerns the most far-reaching and fundamental questions of the organization's life and its impact on its employees, patients, and community. Adequate ethical reflection requires four key elements: participation of the community of concern, that community which represents all the major aspects of the problem at hand; a consensus on fundamental value priorities; shared critical methodology and conceptual tools; and appropriate process and structures. The principal focus here is on the consensus of value priorities. An agreement on general values such as justice, charity, and compassion can be assumed to exist, but dealing with specifics reveals considerable diversity and even conflict. Therefore a group charged with governance responsibilities must build a consensus on the meaning of key values in terms of making specific decisions and then further specify these values in probing questions, key indicators, criteria, and auditing methods.