Evaluating ethics committees: a view from the outside.

More than 60 percent of hospitals have ethics committees. The wide-scale, voluntary adoption of these committees by hospitals is surprising, given the lack of data on their effectiveness. Little effort has been made to evaluate such committees, in part because of the lack of consensus on their purpose. The argument presented here is that, from a policy perspective, the committees' purpose must be to safe-guard patients' interests; a framework for evaluating committees based on that objective is outlined. The criteria for evaluation include access, quality, and cost effectiveness. Existing data used to assess ethics committees, using these criteria. Based on available data, it is questionable whether ethics committees are performing any better or worse than alternative mechanisms to achieve the same goal.