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Ethics Rounds at the Nursing Home: An Alternative to an Ethics Committee
Author(s) -
Libow Leslie S.,
Olson Ellen,
Neufeld Richard R.,
MarticoGreenfield Theresa,
Meyers Helene,
Gordon Natalie,
Barnett Peggy
Publication year - 1992
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1992.tb01836.x
Subject(s) - medicine , nursing , presentation (obstetrics) , medical ethics , multidisciplinary approach , informed consent , population , nursing ethics , family medicine , alternative medicine , sociology , environmental health , pathology , psychiatry , radiology , social science
The increased attention in US medicine to medical ethics reflects in large part the “new” demography of a growing elderly population and the conflict of whether decisions regarding medical care should be based on cost‐effectiveness or “human‐effectiveness.” Currently, about 40 percent of the nation's elderly end up in nursing homes where they confront ethical and legal dilemmas that would not arise in their own homes. In the nursing home, difficult medical‐ethical decisions generally rely on two approaches: the often used but frequently invalid concept of informed consent and little used ethics committees. At The Jewish Home and Hospital for Aged in New York City we have developed a program of “ethics rounds” as an alternative to ethics committees. We conduct the rounds in the open style of a forum or clinical conference rather than with the aura of a decision‐making group. We encourage the participation of patients and family and seek to educate the staff, any one of whom may choose to attend. The rounds consist of a multidisciplinary case presentation, an interview of patient and/or family, a discussion by the staff, and an overview by an ethicist. Staff response to the educational and interdisciplinary aspects of the rounds has been remarkably positive.