Ethics Committees: Allies in Long-Term Care (1990)

Abstract

Developed by the American Association for Retired People (AARP)'s Special Projects Section in cooperation with the American Association of Homes for the Aging's Commission on Ethics this program is intended for the staff and governing boards of long- term care facilities. The three vignettes demonstrate the value and importance of having an ethics committee and illustrate ways in which the committee can aid in decision making about long-term care. Joanne Lynn, M.D. moderates the committee which is show sitting around a room. Mrs. Edwards refuses further treatment for her cancer and wishes to stop chemotherapy. Her son questions her competency and considers guardianship. The ethics committee, a minister, social worker, etc. discuss "quality of life," cultural, racial, and religious background. They consider the needs of the patient, but also those of the staff and the family. Mr. Abrams may need to be restrained for his safety, but his son and daughter view this as abuse because he is restrained against his will. The Committee looks at safety, rights, a written agreement, etc. They recognize that restraints can be seen as punishment because of the loss of control. Mrs. Grecco is frail but refuses to eat; her daughter also says that her mother should not be force fed. The long-term care facility has a policy of tube-feeding in this situation. Caregivers must learn that everyone dies; respect for diversity of opinion; staff needs to discuss personal/institutional value and view of death. The consumer could be very angry if her wishes are not honored. Weigh benefits and burdens, explore alternatives, offer diversity and different perspectives, caregiver, ethical issues, staffing issues. Others appearing are Vera Meyer and Barb Mishkin. Contains program book with discussion questions and information about using the program. The guide also lists some resources for forming an ethics committee.