N108: Transition to the Registered Professional Nurse Role Study Guide Bioethics Bioethics is a new field of study, which is a subset of a larger field of ethics and involves the choices that patients, families, and healthcare providers must make in healthcare situations. Bioethics is defined as a discipline dealing with the ethical implications of biological research and applications, especially in medicine. The bioethical issues surrounding the delivery of healthcare grow in number each year, constantly changing and taking on new scope and proportions. For years we have debated issues related to birth and death; today, those topics respresent just the tip of the iceberg. Of equal or greater concern are such matters as universal access to healthcare and insurance for all, rationing of healthcare, cost containment and quality of care, where and how federal dollars should be spent with regard to the nation’s health, and the obligation of others to assist the homeless. Ethics Committees Most hospitals are now required to have an ethics committee. Historically, ethics committees involved individuals from diverse backgrounds who supported health care institutions with three major functions: providing clinical ethics consultation, developing and/or revising policies pertaining to clinical ethics and hospital policy (eg, advance directives, withholding and withdrawing life- sustaining treatments, informed consent, and organ procurement), and facilitating education about topical issues in clinical ethics. The underlying goals of traditional ethics committees are the following: • To promote the rights of patients • To promote shared decision making between patients (or their surrogates if incapacitated) and their clinicians • To promote fair policies and procedures that maximize the likelihood of achieving good, patient-centered outcomes • To enhance the ethical environment for health care professionals in health care institutions Ethics committees help resolve ethical conflicts and answer ethical questions through the process of consultation. They address both clinical and organizational ethics issues, such as integrating ethics throughout the health care institution from the bedside to the boardroom, promoting ethical leadership behaviors, such as explaining the values that underlie decisions, stressing the importance of ethics, and promoting transparency in decision making. Ethics committee members usually represent major clinical services and other stakeholders in health care delivery. Many ethic committee members include clinicians (physicians and nurses) from medicine, surgery, and psychiatry, social workers, chaplains, and community representatives. These committees may also have a quality improvement manager, an individual responsible for the education program at the facility, a lawyer, and at least one individual with advanced training in ethics.