Medical ethics committee decisions lack quality review, says Dr. Leslie Norins, on OpEdist.com
Medical ethics committees (MEC) make many life and death decisions affecting patients. Yet it is unclear who, if anybody, validates the quality of their membership or their work, says Leslie Norins, MD, PhD, editor of the web forum OpEdist.com.
He describes this current MEC situation as “the perfect trifecta of ‘uns’: unlicensed, unregulated, unaudited.”
Forty years ago, Dr. Norins created and launched the first professional advisory newsletter for hospital MECs, Medical Ethics Advisor. (It was subsequently acquired by another company, which publishes it today.)
Having a MEC is mandatory for hospitals, according to The Joint Commission, the leading certification body for healthcare facilities.
However, there are no rules for qualifying to be a member of an MEC. And, Dr. Norins says, apparently anybody can call himself a “medical ethicist” without penalty. He labels this a “do it yourself” situation, and compares it to instantly obtaining an online certificate permitting one to perform marriages.
Another gap in quality assurance for MEC decisions is the lack of any required reviews or audits by third parties, he says.
The absence of detailed scrutiny of MECs by accrediting bodies has been noted recently by several leading medical ethicists. In response, The Joint Commission issued a statement stressing its continuing interest in hospital ethics. But Dr. Norins calls this a “benign edict, with no teeth to assure quality of an MEC’s membership or its decisions.”
Dr. Norins says medical ethical challenges will increase with advances in biomedical technology and genetics, and the rise of artificial intelligence systems.
Thus, he says it is time for MECs membership and decisions to be subject to the proven procedures of quality assurance employed in other niches of medicine.
