Fleetwood J E, Arnold R M, Baron R J
Medical College of Pennsylvania, University of Pittsburgh.
J Med Ethics. 1989 Sep;15(3):137-42. doi: 10.1136/jme.15.3.137.
Institutional ethics committees (IECs) are part of a growing phenomenon in the American health care system. Although a major force driving hospitals to establish IECs is the desire to resolve difficult clinical dilemmas in a quick and systematic way, in this paper we argue that such a goal is naive and, to some extent, misguided. We assess the growing trend of these committees, analyse the theoretical assumptions underlying their establishment, and evaluate their strengths and shortcomings. We show how the 'medical consultation' model is often inappropriately applied to IECs and suggest that IECs must operate under a different framework. Finally, we argue that IECs should be valued for the process they facilitate, and not for the product that they are, often unreasonably, expected to deliver.
机构伦理委员会(IECs)是美国医疗保健系统中日益普遍的现象的一部分。尽管促使医院设立IECs的一股主要力量是希望以快速且系统的方式解决棘手的临床困境,但在本文中我们认为这样的目标是天真的,并且在某种程度上是误导性的。我们评估这些委员会不断增长的趋势,分析其设立背后的理论假设,并评估其优点和缺点。我们展示了“医学咨询”模式如何经常不适用于IECs,并建议IECs必须在不同的框架下运作。最后,我们认为IECs应因其所促进的过程而受到重视,而不是因其经常被不合理地期望产生的结果而受到重视。