Formal hospital ethics committees didn't emerge until the 1980s, making them a relatively young advancement in modern healthcare. Landmark healthcare ethics cases and changes in U.S. legislation over the decades helped lead to the development of hospital ethics committees as we know them today.
Ethically questionable research practices, a focus on human rights, and rapidly advancing medical technology through the last several decades have significantly impacted the realm of ethics in healthcare. As a result of public awareness of unethical research practices and as specific judicial cases emerged, both formal and informal recommendations were made from various sources to form committees that aimed to address ethical issues in hospitals.
This chapter includes a brief overview of some of the major contributing events.
Several events in recent human history revolutionized the ways in which the scientific and healthcare communities relate to individuals and the general public. The events, as described in this chapter, exemplified utter disregard for human and civil rights. While unethical practices and behaviors in human society likely existed for thousands of years, the utilization of mass media in the 20th century— including newspaper, television, and ultimately, online sources—increased public awareness of ethically charged issues. The public's awareness of human and civil rights violations resulted in the pressure on governments to enact protective statutes. These laws, developed to protect humans involved in scientific research and consumers of healthcare services, fundamentally changed the practices within those industries.
Ethical issues surrounding human subjects research began to emerge in the postwar era of the late 1940s during the criminal trials in Nuremberg, Germany. German physicians, as well as political administrators, conducted thousands of experiments on concentration camp prisoners without their consent. The physicians and administrators were tried and convicted for their participation in war crimes and crimes against humanity.
At the conclusion of their trials, the Nuremberg Code was established in 1948. This code promotes the concept of informed consent, stating that individuals who participate in research should know about the research. Additionally, the Nuremberg Code indicates that research should only be conducted if the benefits of the research outweigh the risk to human subjects (Shuster, 1997).
In the 1950s, the drug thalidomide made national and international headlines for causing fetal deformities in over 12,000 babies. Although the drug had been used in Europe, the U.S. Food and Drug Administration had never approved its use. Physicians prescribed the drug to women during pregnancy to help with nausea and vomiting. However, the women were not told that the drug was not FDA-approved. Subsequent governmental hearings led to amendments to the Food, Drug, and Cosmetic Act in 1962, which requires pharmaceutical companies to obtain FDA approval before they can market their products ...