Integrating ethics with quality assurance in long term care.

Pressing ethical issues, such as the appropriateness of resuscitation and decision making for incompetent patients, frequently arise in conjunction with long term care. Institutional ethics committees can help long term care facility personnel and patients address ethical concerns. Interfacility ethics study groups can be organized to meet the needs of facilities with limited resources. Compliance with ethical policies (eg, regarding decisions to withhold or withdraw life-prolonging treatment, artificial nutrition and hydration, and use of chemical and physical restraints) can be monitored as part of a facility's quality assurance program.