A qualitative analysis of eight hospital ethics committees in Toronto, Ontario

grantor: University of TorontoThe purpose of this study was to develop an in-depth understanding of HECs Role in the Greater Toronto Area and in particular to discover through written questions and focus group interviews, the experiences, perceptions and opinions HECs had about their role. The convenience sample consisted of the chairperson and members from eight HECs. This study employed an exploratory, interpretational approach to data analysis based on grounded theory and an adaptation of the constant comparative method. HECs in the Greater Toronto Area portrayed themselves as lacking a defined role. There were three reasons for this situation. First, HECs in Toronto found themselves in various stages of development. Second, there was a lack of a clear connection between the HEC and the broader hospital community. Third, HECs in Toronto were disconnected from each other and rarely collaborated on issues. The interpretive frameworks expert role, pair-of-hands, and powerless collaborators provided a more in-depth understanding of the HEC role. Expert role. Consistently emerging from the study was the idea that HECs needed to acquire an expert role to avoid becoming simply another hospital committee. The perception of a lack of power and authority which HECs sometimes experienced was profoundly disturbing to some focus group participants: however, these members reconciled themselves to their role with the consideration that they had a moral authority that could not be ignored. In this study, HECs believed the experience of ethical debate with representatives from different professional/occupational backgrounds helped to expand their understanding of problems. The principle of interdisciplinary HECs, which was experienced as broadening the individual committee member's perspective, was specifically endorsed by members of each focus group as a valuable process. Pair of hands. The HEC can be seen as a pair of hands assisting the health care professional, responsible for the patient by being a resource. The HEC functions identified were: development and review of policy; providing a forum for ethical discourse; providing a listening function; assisting with ethical problem-solving and raising the ethical conscience of the hospital. Patient care consultation was not a major function of any of the participating committees. Powerless collaborators. The HECs in this study saw themselves as ethical guides for administration and staff rather than as decision-makers. Collaboration with other health care professionals in the provision of ethical patient care is one area that cries out for the involvement of HECs.Ph.D