Kyler Squirrell The Role of Community Members in Bioethics Committees The art of implementing public health policies is to balance the line between focusing on medical practicalities and the nuances of a population. A medically perfect protocol will invariably fail if not given the means to disseminate within a population, and a policy sculpted to fit a population’s needs will provide no benefits if not based upon medically relevant foundations. Within Guinea, Africa, this equilibrium was analyzed through the presentation of HIV/AIDS public health advisories (Arriola & Grossman, 2021). The researchers determined that the most effective means to encourage communities to pursue HIV testing was to utilize individuals with similar social identities and close relationships with the targeted community to convey the messaging. The existence of identifiable policymakers that individuals in a community can identify with significantly increased the efficacy of health advisories, emphasizing the importance of a policy’s speaker in determining how well it is received. This responsibility placed on a speaker can ultimately be extrapolated to any area of medicine that similarly implements policies and protocols. For example, the role of hospital bioethics committees closely parallels public health policy as they both have the responsibilities of designing and implementing novel policies for a specific community (Aulisio & Arnold, 2008). The nature of a bioethics committee is to facilitate the interactions between the medical staff of the hospital and the patients who are receiving care. It is often the case that these committees must navigate the specific nuances to an individual’s case to identify where the ethical problem arose between the physician and the patient. Overtime, it is the committee's duty to identify common problems within the protocols or methods of a hospital’s delivery of care to create novel policies that prevent the ethical dilemma from occurring in the future. The most pivotal points in this process are where the committees communicate with the patient and the surrounding community, for as it was observed from Guinea, the individuals communicating with the public controls the efficacy of the policy. The importance of this communication is further emphasized by a preexisting air of distrust within many communities in the United States and medical institutions (LaVeist et al., 2009). The insidious nature of distrust within a healthcare setting eliminates the utility of any health policy that doesn’t directly attempt to improve communication and trust, creating an important objective for the individuals within the committees to prioritize connecting with the community. To further the importance of community connection, evidence from a systematic review on the topic of community involvement in health services concluded that greater community involvement within the development of health policy led to a positive impact on health (Haldane et al., 2019). As the communities affected by health policies begin to work with the medical institutions, the policies can become more effective at promoting the health and wellbeing of the hospital’s community. With this evidence and the understanding of the importance of the relationship between bioethics committees and the community they serve, the perfect role of a community member within the committee is to act as a liaison to facilitate the implementation of ethics policies. Only a member of the community has the ability to garner the trust needed from their peers to authentically identify areas where ethical supervision is required and then implement a viable and effective solution to these dilemmas. In order to specifically detail the responsibilities of a community member on a bioethics committee, we can utilize the HIV testing study performed in Guinea, Africa as a model. Hypothetically, if a hospital’s bioethics committee is tasked to tackle an ethical dilemma surrounding systems to maintain patient privacy during HIV testing visits, a community member will be essential in this task to communicate with the public. Given the level of stigma that surrounds HIV/AIDS, ensuring that the community is aware and trusts the new alterations to the privacy concerns is vital to the policy’s efficacy. A community member will then be tasked to sculpt the messaging in a manner that will be received most readily by the community and to deliver the message as a trusted source. This role will place the community member in the most advantageous position for the hospital’s bioethics committee to resolve ethical issues. The evidence from different communities around the world points towards the necessity of community members' involvement with policy development and implementation. Given that one of the fundamental functions of a bioethics committee is to identify ethical problems complicating the delivery of healthcare to the community and then devise long-standing protocols to permanently resolve recurring issues, it is clear that a community member must be situated on a hospital’s bioethics committee to act as a representative for the community. Bioethics committees have the greatest chance of achieving their objectives if the surrounding community can trust and relate to the committee’s decision, and only a fellow member of the community is poised perfectly to fulfill this role. References: Arriola, L. R., & Grossman, A. N. (2021, July 1). Ethnic Marginalization and (Non)Compliance in Public Health Emergencies. The Journal of Politics, 83(3), 807–820. https://doi.org/10.1086/710784 Aulisio, M. P., & Arnold, R. M. (2008, August). Role of the Ethics Committee. Chest, 134(2), 417–424. https://doi.org/10.1378/chest.08-0136 LaVeist, T. A., Isaac, L. A., & Williams, K. P. (2009, November 13). Mistrust of Health Care Organizations Is Associated with Underutilization of Health Services. Health Services Research, 44(6), 2093–2105. https://doi.org/10.1111/j.1475-6773.2009.01017.x Haldane, V., Chuah, F. L. H., Srivastava, A., Singh, S. R., Koh, G. C. H., Seng, C. K., & Legido-Quigley, H. (2019, May 10). Community participation in health services development, implementation, and evaluation: A systematic review of empowerment, health, community, and process outcomes. PLOS ONE, 14(5), e0216112. https://doi.org/10.1371/journal.pone.0216112
