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Directed decisions: Moral authority ...

Lenahan, Kimberly Spencer.

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Directed decisions: Moral authority and the formation of hospital ethics committees in late twentieth century Cleveland.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Directed decisions: Moral authority and the formation of hospital ethics committees in late twentieth century Cleveland./
Author:	Lenahan, Kimberly Spencer.
Description:	261 p.
Notes:	Source: Dissertation Abstracts International, Volume: 55-04, Section: A, page: 1073.
Contained By:	Dissertation Abstracts International55-04A.
Subject:	History, United States. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoeng/servlet/advanced?query=9425535

Directed decisions: Moral authority and the formation of hospital ethics committees in late twentieth century Cleveland.
Lenahan, Kimberly Spencer.

Directed decisions: Moral authority and the formation of hospital ethics committees in late twentieth century Cleveland. - 261 p.

Source: Dissertation Abstracts International, Volume: 55-04, Section: A, page: 1073.

Thesis (Ph.D.)--Case Western Reserve University, 1994.

This historical study focuses on the changing locus of moral authority in twentieth century American hospitals. During the 1970s, some hospitals began forming ethics committees to assist physicians in the resolution of controversial treatment decisions. In the mid-1980s, the organization of ethics committees by hospitals expanded sensationally. Examination of the origins of four hospital ethics committees in Cleveland, University Hospitals Critical Care Advisory Committee, Cleveland Clinic Bioethics Committee, St. Luke's Hospital Ethics Committee, and the Cleveland Veterans Affairs Bioethics Committees reveals that hospital ethics committees had limited influence on medical decision making for individual patients. They have not altered the prevailing physician-patient relationship in medical decision making. Nevertheless, ethics committees did establish an important role for themselves as a forum for deliberating the ethical issues in medical decisions, and creating institutional policies.Subjects--Topical Terms:

1017393
History, United States.

Directed decisions: Moral authority and the formation of hospital ethics committees in late twentieth century Cleveland.
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100 1 $a Lenahan, Kimberly Spencer. $3 1944150
245 1 0 $a Directed decisions: Moral authority and the formation of hospital ethics committees in late twentieth century Cleveland.
300 $a 261 p.
500 $a Source: Dissertation Abstracts International, Volume: 55-04, Section: A, page: 1073.
502 $a Thesis (Ph.D.)--Case Western Reserve University, 1994.
520 $a This historical study focuses on the changing locus of moral authority in twentieth century American hospitals. During the 1970s, some hospitals began forming ethics committees to assist physicians in the resolution of controversial treatment decisions. In the mid-1980s, the organization of ethics committees by hospitals expanded sensationally. Examination of the origins of four hospital ethics committees in Cleveland, University Hospitals Critical Care Advisory Committee, Cleveland Clinic Bioethics Committee, St. Luke's Hospital Ethics Committee, and the Cleveland Veterans Affairs Bioethics Committees reveals that hospital ethics committees had limited influence on medical decision making for individual patients. They have not altered the prevailing physician-patient relationship in medical decision making. Nevertheless, ethics committees did establish an important role for themselves as a forum for deliberating the ethical issues in medical decisions, and creating institutional policies.
520 $a Social challenges to medical values and claims for individual rights incited rebellion against medical authority during the late 1950s and 1960s and motivated a search for means to expand participation in medical decision making. In 1975, the case of Karen Ann Quinlan fostered the formation of ethics committees in hospitals. However, ethics committees never effectively challenged prevailing decision making practices. Physicians and health care organizations began promoting the formation of ethics committees and most hospitals began creating them in response to events launched by the Baby Doe court cases in the early 1980s.
520 $a This study analyzes the expansion of both hospital ethics committees and professional clinical ethics, the significance of the competition between these two alternatives for the implementation of ethics in the hospital environment, and the impact of competing professional agendas in ethics committees. The ethics committee, as an interdisciplinary group, was unable to establish an independent claim of moral authority in the professionally structured, hierarchical medical environment. However, as a professional forum, ethics committees helped effect an attitudinal change toward medical decision making and provided a setting for grappling with moral issues and establishing institutional guidelines for acceptable ethical medical practice in hospitals.
590 $a School code: 0042.
650 4 $a History, United States. $3 1017393
650 4 $a History, Modern. $3 516334
650 4 $a Health Sciences, General. $3 1017817
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710 2 0 $a Case Western Reserve University. $3 1017714
773 0 $t Dissertation Abstracts International $g 55-04A.
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792 $a 1994
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoeng/servlet/advanced?query=9425535