Drawing from the totality of your prior experience and your learning, please address this leadership problem:
At your hospital, the Committee on Medical Ethics is a Medical Staff Committee. It answers to the Medical Executive Committee and the Medical Staff President, and its members are jointly appointed by the President of the Medical Staff and Committee Chair.
Although it is a Medical Staff Committee, its membership is multidisciplinary, including physicians, nurses, social workers, lawyers, and members of the lay public (for community representation).
Most members of the committee have received training in clinical ethics consultation, and were chosen because of their interest in resolution of ethical issues and their interpersonal qualities with patients and staff.
The hospital administration has engaged a consulting firm to “modernize” its structure. The consultants have advised converting the “old” social worker approach to the contemporary position of case manager. The consultants note that three social workers sit on the Ethics Committee.
The social worker members of the Ethics Committee have been told that they will no longer serve on said committee, and that their place will be taken by the Manager of Case Management, who has no experience in ethics consultation, nor does she know anything about the history of Ethics Committee activities at your hospital.
The Chair of the Ethics Committee is informed that three of his committee members are “out.” The Chair is livid, and there is also an immediate reaction from all the rest of the committee members, most especially the medical staff members of the committee— something about separation of powers is mentioned.
You have been assigned by the Hospital Administrator to “handle this mess.” How would you go about doing so? If you had been told to handle the proposed committee reconfiguration from the very beginning, what would you have done differently from what was done?
How to “handle this mess”:
This situation can be handled diplomatically. In my opinion, it would help if “your” position and/or relationship with the Committee members was mentioned as this can have a bearing on the “change” response by the Committee members but also on your impending proposal for the consultants.
It doesn’t appear as though cognitive and behavioural changes need to take place in this kind of conflict resolution/management. What has happened is that a decision was made, whether by the consultants or by a Board member which is not clear and it negatively affects members of the Committee without adequate justification. Thus, it proves that a member of the Committee, or even two or three members, should be working closely with the consultants. Consultants typically make a report first and then it is reviewed by the appropriate boards before implementation takes place so this “decision” seems to be disassociated with appropriate ethical protocol.
A proposal should be made stating the following:
-Why is there an Ethics Committee?
-What is its mandate/mission?
-Its present structure and a justification
-Its constitution or charter
-Why is there a need for modernization?
-What the structural role of the consultants should be (i.e. Terms of