Responding to JCAHO standards: everybody's business.

At this stage, JCAHO [Joint Commission on Accreditation of Healthcare Organizations] site visitors simply want to know how the institution plans to respond to the organization ethics standard. In the near future, however, they will expect data on how ethical issues have been addressed that faced the organization in marketing, billing, managed care contracts, and so on. Pointing to an organizational code of ethics will not be enough. Examples of leadership utilizing the processes of the committee or an appropriate consultant or group, to the ends of education, policy studies, and consultation on specific choices will meet the standard. Organizations that evade or choose not to supply data along these lines will presumably be negatively evaluated. Noncompliance presumably means a risk to accreditation. The message to the clinical ethics committee is a serious one. We must engage in the regional planning and organization needed to provide education and training needed by ethics committees for these two tasks, within the constraints of realism, that is, that these are requirements that are primarily expected of the clinical community and the organizations that provide care to patients.