Adherence to the AAP's Institutional Ethics Committee Policy Recommendations

Area of Science:

• Pediatric Bioethics
• Healthcare Management
• Clinical Ethics

Background:

• The American Academy of Pediatrics (AAP) established 8 operational recommendations for pediatric institutional ethics committees (IECs) in 2019.
• Assessing adherence to these guidelines is crucial for ensuring effective ethical oversight in children's hospitals.

Purpose of the Study:

• To quantify the degree of adherence of pediatric institutional ethics committees (IECs) to the AAP's 2019 operational recommendations.
• Identify specific areas where pediatric IECs fall short of established best practices.

Main Methods:

• An electronic survey was distributed to ethics points of contact within the Children's Hospital Association membership in spring 2022.
• Nineteen pre-identified survey questions assessed adherence to AAP best practice standards.
• Survey responses were analyzed using frequencies and categorized to evaluate compliance with AAP IEC policy recommendations.

Main Results:

• A 65% survey completion rate (117/181) was achieved.
• Significant practice gaps were identified, including lack of membership diversity, insufficient training for competency, inadequate quality improvement, and limited scope of ethics services.
• Over 25% of IECs do not systematically inform hospital staff about ethics consultancy services, and 19% fail to inform patients or families.

Conclusions:

• Pediatric institutional ethics committees (IECs) are not consistently following the AAP's operational recommendations.
• Further research is needed to identify barriers and enablers to enhance IEC practices in children's hospitals.