THE ROLE OF AN ETHICS COMMITTEE IN A REHABILITATION SETTING

The ethics committee, initially developed in the acute care setting, c an serve to address the particular issues and difficult dilemmas that characterize rehabilitation. The same mechanisms of educational progra ms, policy development, and case consultation serve to address ethical issues in rehabilitation as well as acute care settings. However, eth ical issues in rehabilitation differ greatly from those common in acut e care settings. Rehabilitation ethics committees must be prepared to consider issues that include the following: procurement of informed co nsent for services that are rarely discrete, variable levels of progra m participation, complex cost-benefit analyses that are subject to les s relevant values and biases, unequal access to services, limits of co nfidentiality, and family/caregiver issues. These difficult issues, pe culiar to rehabilitation and made much more complex when patients exhi bit cognitive deficits, provide an opportunity for rigorously testing the utility of ethical theory in a complex medical arena.