LETTER
Ethics Committees, Due Process, and Compassion
Thomas E. Finucane, MD
1 September 1994 | Volume 121 Issue 5 | Pages 386-387
TO THE EDITOR:
Both articles about ethics committees refer to the lack of due process when complex and often tragic decisions about care are made [1, 2]. In the nursing home, we frequently have ill, suffering patients with marginal ability to make decisions about burdensome treatments that might prolong life. How do we decide? The people who care for the patients and those who love them put their heads together and try to determine what is right.
At one extreme, sick persons or their families could retain the services of a lawyer to ensure that all patients' rights were fully protected. At the other extreme, physicians could care for patients as they see fit, with licensure and malpractice as sanctions. Ethics committees lie somewhere in the middle. They are a good idea, but moving them toward the legal end of the spectrum will not improve patient care.
The adversarial model, in which everyone asserts their rights, is a little incongruous when people are ill, suffering, and near death. For some patients, compassion is a more important consideration than autonomy, survival, or even procedural due process.
1. Fleetwood J, Unger SS. Institutional ethics committees and the shield of immunity. Ann Intern Med. 1994; 120:320-5.
2. Fletcher JC, Hoffman DE. Ethics committees: time to experiment with standards. Ann Intern Med. 1994; 120:335-8.
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