Ethics Case Review in Health Care Institutions

Traditionally, review of difficult ethical problems that emerge in the care of patients has been performed by hospital ethics committees. It has been proposed that this case review would be more effectively conducted by individual clinicians who are skilled in ethical analysis, much as medical consultations are provided by specialists.¹,²In this article, we will discuss the potential advantages and disadvantages of both the committee and consultant models for ethics case review in health care institutions. We suggest that neither model should be used exclusively, as each is more appropriate than the other under certain circumstances. Furthermore, we recommend that consideration be given to a third model, wherein cases are reviewed by a consulting team of three or four individuals of varied disciplines and expertise. The use of this alternative can retain the virtues of both committees and consultants without succumbing to the limitations of either. There appears to