ETHICS COMMITTEES IN SOUTHERN BAPTIST-RELATED HOSPITALS:
SURVEY RESULTS AND ANALYSIS
By Raymond E. Higgins II, Ph.D., and Steve W. Lemke, Ph.D.(1)
What is the current status and function of ethics committees in Southern Baptist-related hospitals? The answers to this question are important for at least three reasons. First, there is an increasing number of and a growing public interest in the complex ethical issues which arise in the medical setting. Second, hospitals which are sponsored by Christian denominations base their mission on the Christian moral tradition. Southern Baptists represent a particular embodiment of that larger moral tradition. Third, Southern Baptist-related hospitals are accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). In order for such hospitals to maintain their accreditation, they must have in place a process for addressing and resolving ethical issues which arise in their institutions. Recent government regulations regarding end-of-life issues have heightened the value of ethics committees to a hospital.
In this article we describe and analyze the results of our study of ethics committees in Southern Baptist-related hospitals, and evaluate our survey results within the context of the hospital ethics committee movement in the United States. The process for conducting our survey went through several stages. A written survey was mailed in September of 1991 to the chief executive officer of twenty-one hospitals. The surveys were completed by a variety of hospital personnel, and all twenty-one hospitals returned the survey. A follow-up telephone survey was conducted during the summer of 1993. Additional information was collected through the spring of 1994. The hospitals which we surveyed exist in nine states: Alabama (2), Kentucky (2), Mississippi (1), Missouri (1), North Carolina (1), South Carolina (2), Tennessee (3), Texas (8), and Virginia (1). The survey posed questions regarding the status, membership, structure, and function of ethics committees.
Existence of HECs
Of the twenty-one hospitals queried, fourteen had an ethics committee, two were in the process of forming a committee, and five hospitals did not have an ethics committee. The first ethics committee was formed in 1984. Seven hospitals formed committees during the 1980s; five formed committees during the 1990s; two were forming committees during the summer of 1993; and two hospitals gave no starting date. Ethics committees are thus a recent phenomenon in Baptist hospitals.
The first ethics committee in the United States was formed in the early 1960's. Referred to as a "treatment committee," this primitive ethics committee in Seattle, Washington addressed the issue of which chronic kidney disease patients should receive hemodialysis treatment.(2) The real stimuli for creating ethics committees occurred on three occasions: the decision of the New Jersey Supreme Court in the Karen Quinlan case (1976); the recommendation of the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research (1983), and the implementation of the so-called Baby Doe regulations (1984-85).(3) Recent formal incentives include the Patient Self-Determination Act of 1991 and the requirement by the Joint Commission on Accreditation of Healthcare Organizations for those hospitals which receive federal funds.
There has been a dramatic increase in the recognition of the need for HEC's over the last decade. A 1983 survey of 602 ra