In 1992, the Joint Commission on the Accreditation of
Healthcare Organizations (JCAHO) passed a mandate that all its
approved hospitals put in place a means for addressing ethical
concerns.Although the particular process the hospital uses to
address such concerns—ethics consultant, ethics forum,
ethics committee—may vary, the hospital or healthcare ethics
committee (HEC) is used most often. In a companion study to
that reported here, we found that in 1998 over 90% of U.S.
hospitals had ethics committees, compared to just 1% in 1983,
and that many have some and a few have sweeping clinical powers
in hospitals.