Hospital Ethics Committees: one of many centers of responsibility.

Ethical reality is coextensive with human dignity. Therefore, one essential way to understand ethics is as the systematic effort to discern the imperatives of human dignity. Seeing ethics in this way highlights the fact that health care institutions have many centers of ethical responsibility (CERs) - the Chief Executive Officer, Board of Trustees, senior management team, etc. The Ethics Committee is only one such CER and not the most important one. These other CERs will benefit from identifying: (1) the fact that they are consistently dealing with ethical reality and making ethical decisions; (2) some critical elements of good ethical decision-making: (i) having the appropriate community; (ii) making the guiding value priorities explicit and specific; (iii) gaining skill in using the needed intellectual tools; and (iv) fashioning appropriate process and structure for discernment.