Fletcher J C, Hoffmann D E
University of Virginia School of Medicine, Charlottesville.
Ann Intern Med. 1994 Feb 15;120(4):335-8. doi: 10.7326/0003-4819-120-4-199402150-00012.
Ethics committees now exist in most hospitals. Their recent establishment in many institutions was a response to a 1991 mandate by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Proposed or new legislation in a few states is elevating the status of these committees, either requiring their use in certain cases, allowing them to substitute for judicial review, or granting immunity to those who follow their advice. Despite these recent JCAHO and legislative developments, it is widely recognized that there is a significant lack of data on the effectiveness of these committees and that committee members often lack the requisite education and skills for effective participation in case consultation. We argue that before granting ethics committees additional authority, there is a need for more research on their performance and a period of experimentation with quality standards governing their membership and operations.
现在大多数医院都设有伦理委员会。它们最近在许多机构的设立是对医疗组织认证联合委员会（JCAHO）1991年一项指令的回应。一些州提出的或新的立法正在提升这些委员会的地位，要么要求在某些情况下使用它们，允许它们替代司法审查，要么给予遵循其建议者豁免权。尽管最近有JCAHO和立法方面的这些进展，但人们普遍认识到，关于这些委员会有效性的数据严重不足，而且委员会成员往往缺乏有效参与病例咨询所需的教育和技能。我们认为，在赋予伦理委员会更多权力之前，有必要对其表现进行更多研究，并对管理其成员资格和运作的质量标准进行一段时间的试验。
