FRAMEWORK FOR CREATING AN ETHICS COMMITTEE
This is a summary of a presentation made to
the London Metropolitan Police, UK
at New Scotland Yard by Prof Geoffrey Hunt in 1997
While this was drawn up with policing in mind,
it has wide application if the necessary amendments are made
WARNING: No policy or procedure is a substitute for a workplace culture of trust and openness. However a good policy or procedure may initiate or enhance such a culture if it is deployed judiciously. Used wrongly policies, procedures and committees may have the opposite effect to the one desired - most importantly, they may disempower by giving employees the impression that responsibility lies elsewhere and not with them. Policies may also be abused, distorted and neglected by managers who think that such policies apply to everyone except themselves. An ethics committee can also, unless the right conditions are provided, wrongly be used by an employer or other person or group to cover their ulterior motives, incompetence, negligence or harassment of others. A lot depends on the level of openness and participation in the committee.
• to review moral soundness of certain policies, practices, initiatives
• to help maintain highest ethical standards
• to help protect and ensure the safety and wellbeing of stakeholders
• to play a role in maintaining consent e.g. participation, information
• to help ensure continuity. clarity. and consistency of purpose
• to establish through a code of conduct a value foundation in relation to misconduct & discipline, complaints, and unsatisfactory performance
2 GENERAL FUNCTIONING Return to TOP of page
Two general types of ethics committee:
Procedural Type. Clear input-output role in the organisation's managerial process. For example, Local research Ethics Committees in UK normally have only medical research proposals (protocols) as an input; and approval, amendment or rejection as an output. Content pre-established by the process. Disadvantage: rather routine and 'closed', not allowing general discussion of policy and practice matters. Advantage: more well-defined and controlling in specified area.
Forum Type. Input-output not clearly defined. More open-ended, acting as a forum for discussion of some selected issue. Not clearly a link in a managerial process. Disadvantage: may suffer from vagueness, unfruitful selection of issues and inconclusiveness. Advantage: allows free-ranging discussion of any relevant matter from corporate strategy to specific practical innovation.
3 SUBJECT MATTER Return to TOP of page
General e.g. Research New techniques, equipment Public concerns / correspondence? Staff concerns / hotline? Managerial concerns Ethical audit Access to records
Specific e.g. Video surveillance Bugging Use of informers Whistleblowing New equipment, weapons Private Security Industry Links Relations with other agencies Pressure to perform
4 EXAMPLES Return to TOP of page
5 AUTHORITY (Some questions) Return to TOP of page
What is the source of the committee's authority? Where does it sit in the organisation's lines of accountability? What authority does it have? By what instruments does it apply its authority? Are decisions of EC binding, or only advisory?
• Statutory
• Under Government Guidelines Note: DoH says of LRECs they 'are not in any sense management arms of the DHA'; Home Office/Secretary of State could require all police forces to set up ECs?
• Inhouse: management-based
• Forums
Does it have disciplinary powers?
What is its relation to Complaints Procedure?
Monitoring powers (compliance?)
Advisory/consultative?
6 ETHICS IN FOUNDATION Return to TOP of page
Ethics committees must be ethical themselves.The need for a constitution begins from that premise. The committee must live by the standards it promotes, and must set an example. An ethical ethics committee has a structure and process which embodies a concern for:
• CLARITY AND DEFINITENESS clearly defined remit and scope
• INDEPENDENCE independence from bias and compromise
• ACCOUNTABILITY accountability to all stakeholders
• PUBLIC SERVICE VALUES The Seven Principles of Public Life (postulated by the UK's Nolan Committee 1995) are Selflessness, Integrity, Objectivity, Accountability, Openness, Honesty, Leadership.
7 ETHICS IN APPLICATION Return to TOP of page
Some principles which will be applied to the matters being considered by the EC:
• Privacy and confidentiality
• Dignity, self-esteem and integrity
• Protection from harm
• Autonomy: Freedoms of movement, speech, etc
• Right to Know
• Justice and Fairness
8 MEMBERSHIP Return to TOP of page
• Whom is it meant to protect? (If we agree it has a protective function.) Managers, the organisation, staff (uniformed/civilian), public, informers, individuals, other agencies, future generations?
• Cf. Helsinki Declaration: 'the interests of science and society should never take precedence over considerations related to the wellbeing of the subject [of research]'.
• Need for co-opted experts on technical questions (e.g. innovations) which have ethical questions.
• Members should be drawn from a cross-section of stakeholders (uniformed staff, civil staff, management, ranks, public nominees/representatives, agencies, etc).
• Membership should include women, ethnic minorities, age-mix.
9 REMIT & JURISDICTION Return to TOP of page
It is better (unless there is a high level of trust and consensus) to have a written constitution covering the following:
• What is the remit of the committee? What kinds of matter it can consider and what sorts of matter are outside its remit must be clearly stated. (E.g. LRECs in UK distinguish between morally acceptable and unacceptable research by scrutinising protocols.)
• EC should have right to scrutinize all the relevant matters within a defined jurisdiction. But what is its jurisdiction? What is not within its jurisdiction should be clearly stated.
10 INDEPENDENCE Return to TOP of page
The constitution should guarantee the independence of the committee i.e. freedom from compromise, bias and ulterior motive.
Safeguards would include: declaration of any conflict of interest by members (with withdrawal of member in appropriate circumstances).
The creation of an EC is different from the maintenance of one; while creation may be top-down, once created then bottom-up initiatives should be instituted.
• Right balance of co-option, nomination and election.
• As wide a range of stakeholders represented as possible. How does representation come about? Nominees only? A committee of experts only?
This is a matter of independence as well as accountability.
11 ACCOUNTABILITY Return to TOP of page
How long should members serve? Possibly 3 years, with possibility of re-election to maximum of another 3 years for core (as opposed to co-opted expert) members. Balance in composition (e.g. in LRECs doctors often vastly outnumber nurses). A good constitution would rule on the precise grounds and procedures for removal and on the notice required for resignation.
Confidentiality balanced against right to know. Note distinction between confidentiality of material which comes into EC's hands and the confidentiality of EC's decisions.
Rules governing remuneration for members; expenses only? Meetings open to public? (Cf Institutional Review Boards in USA) Honest, accurate and informative Annual Report.
Legal liability is an issue with LRECs, if an approved protocol is claimed to have done harm. Is it any issue with every EC? Need for legal expert on EC?
12 OPERATIONAL PROCEDURES Return to TOP of page
A constitution should cover:
• Chair and secretary elected from members
• Women and men, age groups, ethnic mix, lay persons
• Duties and powers of officers; chair no more than 3 years, renewable another 3?
• Size - between five and 16, depending on size of organisation / diversity of stakeholders
• Sub-committees, focus groups
• Lay representation
• Fixed regularity of meetings
• Postal/phone correspondence should be restricted to exceptional circumstances
• Decisions - by consensus (allows dissenting voices to be heard), majority (e.g. 2/3) or unanimous.
• No weighted votes or power of veto?
• Chair's action only under narrow and defined circumstances
• Quorum (e.g. two-thirds)
• Minutes / Annual Report
REFERENCES Return to TOP of page
Hunt, G. (1990) 'A Constitutional Framework for Ethical Review Committees', Journal of Management in Medicine 4 (3)155-159. Hunt, G. (1992) 'Local Research Ethics Committees and Nursing: A Critical Look' British Journal of nursing 1(7)349-351. E Clark & G Hunt (1994) Ethics in Nursing and Midwifery Research, Distance Learning Centre, South Bank University, Module 6, Section 4: Codes & Committees.