Educate just like the professionals
Curricula provide goals, direction
If you're considering starting a formal education program for your ethics committee, do what professional teachers do: Develop a curriculum. That's what the ethics committee co-chairs did at the University of Texas Medical Branch at Galveston.
"The curriculum is fluid and probably not as rigid as say a primary school teacher's would be, but it was developed from our own committee," says Michele Carter, PhD, com mittee co-chair and consultation service direc - tor at the University of Texas Medical Branch at Galveston.
Unlike in school, however, members of the committee aren't tested. "There's no testing as part of the monthly meeting because we're not trying to certify a consultant, so it's not as formal as a classroom setting," Carter says.
The curriculum was developed from two sources. "This year, we asked members of the committee to rank a list of top 10 concerns in ethics that they felt they needed additional education in. Also, a set of cases or problems are extracted from the consultations provided by the consultation service during the previous month, and that becomes a focus topic for the upcoming meeting." (See top 10 chart, below.)
The educational efforts for the ethics committee are part of a larger ethics program at the Univer sity of Texas Medical Branch, says Carter. The ethics program has been in place since 1993 and includes three interrelated components, she says.
DIscussions come from actual consults
The first component is the consultation service, which is staffed by four ethicists. Both co-chairs of the hospital's committee serve as consultants. "The cases and problems we present to the committee for the focus topic come from the con sultations we provide during the preceding month," Carter explains. (For a sample of the problems used for teaching in the program, see box, p. 43.)
Clinical ethics teaching rounds are the second component. "We have weekly and monthly conferences on ethical issues in several units. Health care providers who are interested in serving on the committee usually express an interest during the rounds."
Units that participate in the teaching rounds include pediatrics, AIDS, burns, neonatology, medical intensive care, surgery, and correctional health.
The final component is the ethics committee itself. Committee members may provide presentations or arrange to have outside speakers, Carter says.
"If there's a focus topic that none of the committee members are comfortable presenting information on, we'll invite an outside source to participate. We always try to have handouts related to the topic to help reinforce what we've discussed."
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