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MUHA Ethics Committee to address issues A Web-based anonymous survey posted by the recently reorganized Medical University Hospital Authority Ethics Committee seeks help in determining which ethics-related activities people at MUSC consider most important. Analysis of the survey results will help the committee set priorities and identify bioethics issues that need to be addressed.   Organized to function in consultation, policy development and review, performance improvement, and education, the committee sees numerous opportunities ahead to develop bioethical guidelines for end-of-life care, advance planning, resource utilization, professionalism and access to health care.   “One of the strengths of the committee is its interdisciplinary membership,” said Sally Webb, M.D., the committee’s chair. She cited representatives from medicine, nursing, hospital administration, pastoral care, law, social work, the community, rehabilitation science, psychology, respiratory therapy, theology, and public relations who work to improve patient care within an ethical framework.   The 25-member committee met in May for the first time in more than two years with the charge to serve as a resource for the hospital authority and staff and patients on the institution’s ethical responsibilities related to clinical and administrative practices.   The committee’s long history at MUSC dates back to 1983 when Biemann Othersen, M.D., asked Family Medicine’s Albert Keller, D.Min., to organize a hospital ethics committee, a rarity among the nation’s hospitals at the time. With a year of preparation behind them, the dozen or so members met monthly to review consultations, policies and educational opportunities. They would convene on request if an ethical dilemma regarding patient care arose.   The committee was chaired originally by Margaret Mohrmann, M.D., then David Garr, M.D., in 1987 and C.D. Smith, M.D., in 1990. By the early 1990s, other health care organizations across the nation were forming their own ethics committees, a trend reinforced in 1991 by the Patient Self-Determination Act. The act required health care organizations that received federal funds from Medicaid or Medicare to form a committee, often an ethics committee, to ensure compliance with the act’s language on advance directives. In 1992, the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) mandated that all its accredited hospitals put in place a “means for addressing ethical concerns” and this requirement still stands.   In 1993, the university hired Mary Faith Marshall, Ph.D., to establish the Program in Bioethics. Marshall studied bioethics at the University of Virginia under the tutelage of John C. Fletcher, Ph.D., a pioneer in the field of clinical ethics and the first bioethicist at the Clinical Center of the National Institutes of Health.  With her background in clinical ethics, Marshall served as the committee’s vice-chair and helped to create a separate Ethics Consultation Service in 1994. Marshall served as a bioethics resource for the hospital and university until she accepted a faculty position at Kansas University Medical Center in 1999, at which time the program in bioethics was eliminated at MUSC.   Recent committee chairs include Frank Brescia, M.D., and Sally Webb, M.D. Webb notes that studies have reported the growth and expansion of hospital ethics committees, so that by 1998, more than 90 percent of health care organizations had one.   The ethics committee will report current activities in upcoming issues of The Catalyst.   Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.