Ethics committees in long-term care facilities.

Biomedical ethical dilemmas occur in long-term care facilities (LTCFs), particularly in the absence of residents' advance directives. Ethics committees are required in hospitals and long-term care facilities accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), but many LTCFs do not have JCAHO accreditation. A survey of LTCFs in one county in a Southwestern state found that only 29% of those LTCFs responding had an organized ethics committee. This article discusses the purpose, membership, and meetings of an ethics committee in LTCFs. A sample process for resolving a biomedical ethical dilemma is presented. Nurses can initiate the development of an ethics committee using available resources or combining resources with other local LTCFs. The ethics committee should consider the education of all persons involved to facilitate resolution of clinical ethical dilemmas.