Helping Solve Biomedical Ethical Dilemmas in Healthcare
Tri-County Regional Ethics Committee (TREC) is a nonprofit group that serves under the New Jersey Long-Term Care Ombudsman office. The committee consists of healthcare professionals such as medical doctors, nurses, social workers, therapists, elder law attorneys and chaplains; 25 of them are specially trained case consultants who provide consultations and mediate between care facilities and families of patients facing biomedical ethical dilemmas.
Jane Knapp joined TREC in 2005 and became the chairperson in 2010. She received extensive training from the state of New Jersey on how to facilitate the biomedical ethical consults. When a long-term care or assisted living facility faces an ethical dilemma regarding the care of a resident, a three- to five- person TREC team will be called for a mediation and ethics consultation.
What is the Role of the Ethics Committee in Healthcare?
“Our point of view comes from the resident,” Jane states. “We advocate for the resident and protect the resident’s rights. Oftentimes, the care staff has certain treatment protocols or opinions about what they want to do, but the family is unsure. Or the family is uncomfortable, or they think, ‘Would Mom have wanted this? Is this necessary?’ Our recommendation will be always on the side of the resident.”
A typical case TREC handles usually involves someone who does not have a clear advance directive and who cannot currently express their own care wishes. Jane said she and her team work to “create a safe environment for people to say things that otherwise they may not be able to say,” which may mean family conflicts over how to best care for a loved one.
Each TREC team weighs in on the options for the resident in question, then suggests recommendations for care facility staff and families. Families members find it hard to make end-of-life care decisions because of doubt and guilt. Jane says the TREC team lifts the burden off the family, even though the direction is not legally binding.
Community Education: Health Care Decision Making
Jane says that people should have conversations about advance care directive with their families while their loved one can still communicate; “My dream as Chair would be to put the biomedical ethics part of it totally out of business. The way we do that is by encouraging people to have these conversations a lot earlier than they are having them. It’s a gift you are giving to those who are left behind.”
“For me, it’s very, very satisfying to see people come to a full resolution or at least step toward it,” Jane affirms. “The thing that I encourage most of all is: Don’t let this happen to you. Try not to be the family who needs a consult. Have a family meeting. The best time to talk about all this is when you are not in crisis.”
