Ethics committees help with tough choices

A group process can resolve disputes and ease family members' anxiety over refusing or withdrawing care.

By Andis Robeznieks, AMNews staff. Dec. 1, 2003.

The case of Terri Schiavo, the Florida woman who has been in a "persistent vegetative state" since her brain was deprived of oxygen during a heart attack 13 years ago, has ignited a very public debate over who decides the course of a patient's medical treatment when the patient can't make that decision herself.

Although most disputes rarely reach the tumultuousness of the Schiavo case, physicians are often called upon to mediate disagreements over an incapacitated family member's medical care. When this happens, some experts agree that convening an ethics committee offers the best hope for consensus building.

"Until you really have a patient or a case that needs the service of an ethics committee, you don't recognize the value they bring," said Thomas A. Kintanar, MD, a Fort Wayne, Ind., family physician and hospice director.

"An ethics committee can help ensure that the decisions made are the best that can be made medically and that can bring the family peace," he said.

A member of the American Academy of Family Physicians Board of Directors, Dr. Kintanar said he was once in a situation similar to the Schiavo case after the decision was made to withdraw the feeding tube of a 23-year-old developmentally disabled woman with microcephaly as a condition of placing her in hospice care. It was a decision that ignited the community and divided the family.

"There was a lynch mob out to get me," Dr. Kintanar said. "She was a beautiful individual, but she was nonresponsive and declining."