Hospital Ethics Committee
From time to time, in the course of hospital treatment, physicians, nursing staff, family members and patients encounter severe moral dilemmas with which the applicable laws alone are an insufficient guide. In these cases, the legal and medical questions involved are accompanied by moral values such as considerations of dignity, autonomy, the protection of life, and care for those in need. Concepts of the human being, religious beliefs and other ethical criteria must be taken into consideration and weighed against each other.
Dialogue in severe moral dilemmas
‘Our hospital can be only as good as the culture in which we deal with one another (...)
In our hospital, the patients as human beings are at the centre of what we do.’
(Excerpt from the Mission Statement of the Municipal Hospital of Pirmasens)
The mission of the Hospital Ethics Committee
The Ethics Committee is active in four areas:
- Patient-related ethical counselling for affected employees, family members and patients
- Staff continuing training for the development of competencies in ethics
- Preparation of recommendations and guidelines
- Advisory assistance on ethical issues within the organisation
The advisory procedure
The following procedure has been established for consultations with the Ethics Committee:
- Completion of the form ‘Request for consultation with the Hospital Ethics Committee’ (available e.g. in rooms within the wards and in the entrance area/ground floor, opposite the lifts)
- Placement of the completed form in the mailbox of the Ethics Committee in the entrance area/ground floor (emptied daily Monday through Friday)
- Members of the Committee (consisting of doctors, nursing staff and other services) convene to examine the application for acceptance.
- If accepted, the members contact the individual(s) seeking guidance as well as participating doctors and nursing staff and collect additional information.
- The members then consult amongst themselves and promptly provide the individual(s) seeking guidance with a written and, where possible, oral presentation of the results of the consultation.
- There is no ‘living will’ and the presumptive will of the patient, who is no longer capable of communication, is not clear. Everyone involved wonders: what steps, or what forms of forbearance, would be in keeping with the patient’s values and concept of life?
- A ‘living will’ is in hand but is formulated in such broad terms that caregivers, doctors and nursing staff are at a loss as to what course of treatment would truly reflect the patient’s will and sense of well-being.
- The possibility of an operation in a medically futile or unpredictable situation is discussed. This gives rise to the human and moral question: is this surgical intervention still humanly responsible?
- Parents and caregivers want to know: what constitutes a humane life for a newborn with multiple handicaps and a short life expectancy, and what are the implications of this for the continuation of treatment?
In cases such as these, it is helpful to enter into an interdisciplinary conversation, to venture into dialogue, to ask the right human questions in a broader cooperative effort, and to seek solutions. Upon request, the Hospital Ethics Committee offers a discussion forum for precisely these kinds of questions.
15 members from all areas and levels of nursing, social work, physiotherapy, pastoral care and the medical profession ensure an open and interdisciplinary dialogue at eye level.
The advisory work of the Ethics Committee takes the form of recommendations.