The study consisted of four national surveys sent to two separate samples. The first target was the ECs of all 80 medical schools and the second target was all general hospitals with over 300 beds in Japan. In July 1995 and August 2002, we mailed a self-administered instrument to the EC at all 80 medical schools. By 1995, all Japanese medical schools had established an EC. Concurrently, we mailed a self-administered instrument addressed to the Chief of Staff at all general hospitals with over 300 beds in April 1996 (n = 1457) and March 2002 (n = 1491). This sample of general hospitals did not include university hospitals.
Instrument
Each instrument contained four sections: (1) committee structure; (2) frequency of annual meetings; (3) committee function; (4) existence of ethical guidelines for the refusal of blood transfusion by Jehovah's Witnesses. We chose to use number four because the existence of ethical guidelines for dealing with Jehovah's Witnesses in Japan can serve as a possible indicator of EC functionality. Two additional sections were included in instruments developed for medical school ECs that pertained to awareness of the binding power of committee decisions and awareness of recent changes in responsibility.
Analysis
All data were edited and analyzed using SPSS Windows Version 11.0 to determine frequency of responses for each category. To measure the strength of association between variables, tests of significance, such as the t test and Chi Squared test, were calculated.
Ethical considerations
The study was approved by the University of Tokyo Graduate School of Medicine Research Ethics Committee. All instruments were mailed with a letter explaining the objectives of the study, protection of personal information, and how all responses were voluntary.
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