OHSU

Institutional Ethics

 Medical Education Mural, by John Sherrill Houser-located in foyer of Library & Auditorium bldg. OHSU.

OHSU Intitutional Ethics Committee Charter

Defintion

"Institutional ethics" refers to an organization's articulation, application, and evaluation of values and moral principles related to its practices, procedures, and policies. In a health care institution, such as OHSU, the term broadly encompasses the ethical principles that apply to the clinical, research, educational, financial, managerial, and contractual components of operation.

There are two important characteristics of an ethical culture in an institution:

  1. It is a culture where the missions and vision of the institution are consistent with its operations and management and these are integrated with ethical goals; and
  2. It demands and facilitates ethical behaviors of those who are associated with the institution.

Objective & Responsibilities

The OHSU Institutional Ethics Committee (OIEC) is advisory to OHSU's leadership in the following ways:

  1. Advice or policy recommendations related to clinical issues -> Key executives and committees at the School/unit level -> Health System Policy Steering Committee -> Professional Board -> University Health System Board.
  2. Advice or policy recommendations related to non-clinical issues -> Key executives and committees at the School/unit level -> Vice Presidents' Committee

The OIEC's role is to provide advice and consultation to assist in the development of local policy and guidance documents for operational units and senior administrators on ethical aspects of issues related to the clinical, research, education, and public service missions.

Guidelines

The OIEC applies ethics principles to the questions and issues that are presented for consideration. Because there are multiple interests in an institutional ethics policy, the OIEC meets with and collects information from multiple sources. In promulgating guidance and advice, the OIEC considers ethics principles, the missions of OHSU, current policies, societal responsibilities, fiscal and operational realities that exist at the time, and the potential effects on attitudes and activities of everyone associated with or impacted by the institution and the specific policy. The work of the OIEC maintains and enhances a culture of ethics at OHSU and thereby, positively impacts all mission areas.

Process

Anyone who has programmatic or jurisdictional authority at OHSU may bring an issue to the OIEC and request advice or policy recommendations. The OIEC will consider whether or not the issue is addressed in other OHSU policy or there are other decision-making authorities responsible for the issue. If this is the case, those other authorities will be immediately consulted prior to any policy development. Should the issue be deemed appropriate and timely for the OIEC, it will perform its analysis and draft its guidance with the close consultation and collaboration of key stakeholders. If there are compelling reasons to postpone OIEC policy work or defer to some other OHSU body that is working on the issue, the chair of the OIEC will periodically follow-up on the progress being made with these outstanding ethical issues. The approval process for the OIEC's advice or policy recommendations will follow the paths outlined above in Objectives & Responsibilities. If the issue is pertinent only to one particular school, unit, or operational area, penultimate approval of the guidance will occur with appropriate persons and/or committees within that area. OIEC recommendations will be presented to the Vice Presidents' Committee and/or the University Health System Board or their designees for ultimate approval.

Requests for guidance will normally be handled by the OIEC in the order received. However, urgent issues that directly affect patient care or well-being or that result from some other exigent situation will be prioritized ahead of other issues that are important, but less urgent in nature. In cases where there are multiple requests of the OIEC, the chair may form sub-committees to deal with individual issues. The work product of these sub-committees will be presented to the full OIEC prior to moving forward as recommendations.

Structure & Membership

The OIEC is comprised of representatives from mission areas, administration, legal counsel, and ethics leaders within OHSU. In addition to standing members of the OIEC, ad hoc members or experts may be invited to attend meetings of the committee to discuss specific issues. The OIEC is chaired by the Director of the OHSU Integrity Office and co-chaired by the Director of the OHSU Center for Ethics in Health Care. The Provost appoints members to the OIEC, based upon the recommendations of the Chair and Co-Chair.

Reporting Relationships

Once policies are adopted by the Vice Presidents' Committee and/or the University Health System Board, the OIEC will coordinate with the OHSU Integrity Office for appropriate posting and links on various OHSU web pages. Any OIEC guidance that would affect or effect a PAC level policy would be routed through the normal PAC process.