Are Ethics Committees in Tune With the “Epidemiology of Ethical Issues”?

Health care ethics committees (ECs) have proliferated over the last 50 years as a consequence of the progressive development of academic bioethics. However, their form of operation is neither homogeneous nor fully satisfactory, and they present a great degree of variability throughout the world, rather like the children of a large family, each with different levels of growth and maturity. The article by Frolic and colleagues (2012) opens the black box to one of their traditional functions: institutional policies on ethical questions. It is a sound article that explains—to the envy of many of us—the excellent work methodology developed by this particular group, and analyzes the quality of the review process as applied to two case studies that are recognizable at any latitude because of their relevance: Advertising Policy and Pediatric Jehovah’s Witness Blood Transfusion Policy. However, we should take advantage of the singular nature of both these issues in order to call attention to whether the activities of institutional review boards are in tune with the epidemiology of the ethical issues arising in the daily existence of the institutions they serve. The questionwe should ask is whether ECs devote their greatest efforts to themost appropriate issues, owing to their prevalence and transcendence, either in clinical cases that cause ethical doubts to arise during the decision-making process, or as ethical guidelines for common areas of clinical practice where there is a significant moral dimension, and, naturally, in the content and form of the educational activity that ECs should be leading. Many institutional review boards can be reproached for existing in a parallel universe to the daily health care provision activities of their institution, as if they were part of a