Institutional ethics committees as social justice advocates

The idea of involvement in social justice issues transcends the traditional responsibilities of most institutional ethics committees (IECs). Yet precedents for such an advocacy role exist in several areas: the development of regulations that protect handicapped newborns from discriminatory decisions of nontreatment and the institutional committees that review research protocols or formulate "do not resuscitate" policies. The need for IECs to take up social justice issues is based in the concepts of autonomy--the capacity for freedom of choice--and relationality--the capacity to known and to love. All the human ethical questions of freedom, well-being, and justice emerge in the health care setting, where the concepts of autonomy and relationality are intently focused on and sometimes threatened. If a health care institution is to address such questions as affirmative action policies in financing and purchasing, the just pricing of medical care, the ethics of treatment decisions, and the right to medical care, it needs a forum in which to deliberate, collaborate, and discern responsible corporate moral action. For example, an ethics committee can: Call for correction of problems of sexism, racism, and classism in health care institutions; Address government regulations in a way that enables a better understanding of professional commitments; and Lead facilities to discover ways to network with others to meet the needs of the populations they serve. Above all, IECs can help health care professionals find a new "hermeneutic" for interpreting the health care mission to allow them greater power to respond to the dignity and the needs of human persons.