title: The changing composition of a hospital ethics committee: a tertiary care center's experience.
abstract: A growing body of research has demonstrated significant heterogeneity of hospital ethics committee (HEC) size, membership and training requirements, length of appointment, institutional support, clinical and policy roles, and predictors of self identified success. Because these studies have focused on HECs at a single point in time, however, little is known about how the composition of HECs changes over time and what impact these changes have on committee utilization. The current study presents 20 years of data on the evolution of the Massachusetts General Hospital HEC. Between 1993 and 2012, the average number of committee members per year was 38±3 and the average length of membership was 4.8±0.4 years. During that time, the committee performed 934 consults, averaging 47±3 per year. Attendance rates fell from 61.5 to 23.8% over the study period and were inversely correlated with the total number of members. Between 1993 and 2012, the committee saw substantial growth in the diversity of the professional backgrounds of its members. Multivariate analysis, however, suggests that substantial changes in committee composition did not impact its utilization and that other factors are more likely to explain fluctuations in consultation volume.
authors.affiliation: Institute for Patient Care, Massachusetts General Hospital, Founders House, 3rd Floor, 55 Fruit Street, Boston, MA, 02114, USA, acourtwright@partners.org.
authors.forename: Andrew
authors.initials: A
authors.lastname: Courtwright
authors.forename: Sharon
authors.initials: S
authors.lastname: Brackett
authors.forename: Alexandra
authors.initials: A
authors.lastname: Cist
authors.forename: M Cornelia
authors.initials: MC
authors.lastname: Cremens
authors.forename: Eric L
authors.initials: EL
authors.lastname: Krakauer
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Robinson
mesh_terms: D018864:Cultural Diversity; D028741:Ethics Committees, Clinical / Q000458:organization & administration*; D006769:Hospitals, General / Q000941:ethics; D006801:Humans; D016014:Linear Models; D008404:Massachusetts; D015999:Multivariate Analysis; D019982:Organizational Case Studies; D062606:Tertiary Care Centers; D000078329:Workforce
references.citation: Arch Intern Med. 1992 Apr;152(4):694-7
references.pmid: 1558424
references.citation: HEC Forum. 1998 Mar;10(1):75-85
references.pmid: 10178385
references.citation: Law Med Health Care. 1991 Spring-Summer;19(1-2):105-19
references.pmid: 1895760
references.citation: Camb Q Healthc Ethics. 2002 Winter;11(1):87-93
references.pmid: 11868423
references.citation: Ann Intern Med. 2000 Jul 4;133(1):59-69
references.pmid: 10877742
references.citation: J Med Philos. 1988 Nov;13(4):411-32
references.pmid: 3246580
references.citation: J Med Ethics. 2007 Jun;33(6):320-4
references.pmid: 17526680
references.citation: J Clin Ethics. 2011 Summer;22(2):151-64
references.pmid: 21837887
references.citation: Am J Bioeth. 2001 Fall;1(4):60-4
references.pmid: 11954647
references.citation: Am J Bioeth. 2013;13(2):3-13
references.pmid: 23391049
references.citation: HEC Forum. 2006 Sep;18(3):222-44
references.pmid: 17650761
references.citation: HEC Forum. 2003 Sep;15(3):287-99
references.pmid: 14686101
references.citation: Hosp Community Psychiatry. 1994 Jun;45(6):576-80
references.pmid: 8088738
references.citation: Am J Bioeth. 2007 Feb;7(2):13-25
references.pmid: 17366184
references.citation: HEC Forum. 1992;4(6):342-59
references.pmid: 10123219
references.citation: HEC Forum. 2010 Mar;22(1):65-72
references.pmid: 20431916
references.citation: HEC Forum. 2012 Jun;24(2):99-114
references.pmid: 22302457
references.citation: Crit Care Med. 1983 Nov;11(11):902-5
references.pmid: 6627962