Articles address issues of integrated systems, authority, and payment.

Ethics committees are continually challenged by matters of identity. Does its membership reflect a fair representation of health care disciplines? Does the committee have the institution's or the patient's best interests at heart? Just when ethics committees seem to be getting a handle on these matters, the political environment is changing, with more hospitals becoming involved in managed care systems. So the question persists, but at a different level. The following articles summarize various ideas being proposed as solutions.