The era of internal regulation of ethics committees ended in 1994 with the Royal Decree of 12 August 1994 that obliged all general and psychiatric hospitals to establish a so-called "local ethics committee". These committees were assigned a guiding and consultative task with regard to the ethical aspects of hospital care and a review task with regard to all protocols concerning human experimentation and reproductive human material. By law, the existing ethics committees also acquired the task to perform ethics consultations; the full ethics committee, or one or more members of the committee, would then provide support for healthcare workers who have to deal with ethically problematic cases.
In 2000 the Belgian Court of Arbitration, established to deal with conflicts of competence in the federal state, overruled this threefold task with its judgement of 31 October 2000 (No 108/2000) that stated that the Belgian federal lawmaker did not have the authority to set ethics consultation as one of the tasks for ethics committees because the competence to legislate on person related issues in healthcare resides with the regional authorities. Through this decision, ethics consultation no longer applies to Belgian ethics committees. The annual activity report of 2001 however indicates that the ethics committees did not refrain from carrying out ethics consultations, despite the ruling.
The Royal Decree of 12 August 1994 also governs the composition of ethics committees. According to the decree, every committee has to consist of at least eight and at most 15 members, the membership of the committee has to represent both sexes, and the majority of members must be associated with the hospital as physicians. It is also obligatory for every committee to contain a lawyer, a nurse, and a general practitioner who is not associated with a hospital. The law further allows for other interested parties to participate as members of the committee. Lastly, the membership of the ethics committee is not only limited in numbers but also by function. The director of the healthcare institution, the chief physician, the chairman of the Medical Council, and the chief nurse are not allowed to sit on the committee.