Hospital Ethics Committees, Consultants, and Courts

Hospital ethics committees grew out of legal controversies regarding the refusal of lifesustaining treatment. We review the fragmented history of hospital ethics committees and argue that though they were born of concerns about legal liability, they do best when they stick to clinical ethics and leave legal questions to a hospital's attorney and the courts. We also underline that procedural mechanisms, including ethics committees and advance directives, have not had a measurable role in improving end-of-life care or reducing end-of-life treatment conflicts.