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The New York City Long-Term Care Ethics Network

Long-term care providers face a spectrum of ethical issues that run the gamut from urgent decisions about life-sustaining medical treatment to broader concerns about the day-to-day quality of life for the chronically disabled. Providers must respond to these issues within a context of ongoing judicial, legislative, and regulatory developments, and within growing public concern about fundamental changes in the health care system and its ability to deal effectively and compassionately with chronic illness, frailty, and end-of-life care.

Long-term care providers face a particular challenge here: health care ethics has long been dominated by acute care concerns and perspectives. In 1984 the New York City Long-Term Care Ethics Network was established in response to the marginalization of long-term care in the general bioethical discussion. The Network is a non-profit organization whose explicit aim is to bring ethical discussion to bear on the specific care practices and organizational structures of nursing homes, home care agencies and other forms of community-based care. Funded by generous grants from the Fan Fox and Leslie R. Samuels Foundation, the Network has developed into a geographic alliance of ethics committees and long-term care professionals from the New York City area. Its board members represent the diverse fields that the Network serves: Social Work, Nursing, Medicine, Law, Administration, Pastoral Care, Consumer Advocacy, and Ethics.

The Network's Mission

The Network provides an ongoing forum and other educational resources for exploring ethical issues in long-term care. The Network seeks to create dialogue between practitioners and researchers, to encourage interchange between the different professions serving long-term care, to sustain an ongoing ethics discussion that is responsive to the legal, legislative, regulatory, economic, and political forces shaping long-term care. In pursuing this mission, the Network is committed to developing a broad-based ethical consensus in long-term care and, at the same time, to presenting the diversity of moral positions that can arise around specific health care issues.

In its focus on care provider issues, the Network has a distinctly practical aim: to serve ethics committees in the educational, policy development, and case consultation tasks they face within their own institutions and agencies. The Network also serves as a resource to individual care providers and to institutions and agencies that do not yet have ethics committees. In regularly bringing together researchers and practitioners, the Network seeks to support existing research and encourage more energetic research efforts within long-term care institutions and agencies.

The Network provides its services through regular conferences, through its speakers' bureau and bibliographic service, and through educational programs and consultations tailored to the needs of individual institutions and agencies. The Network's expanded newsletter, now sent to over 1,500 long-term care professionals, provides articles on critical issues in long-term care ethics, reports on Network conferences and services, and highlights related resources and activities in the New York City area. The Network's web site is at

Ethical issues that are critical to the Network and that provide the focus for its conferences, workshops, and newsletter: