This study is subject to several limitations. First, the response rate among general hospitals was low, yet since the ratio of established hospital ECs in this study was similar to that officially reported by the Ministry of Health, Labor and Welfare, this study's sample is thought to be representative. Second, we cannot determine whether nonrespondents would have answered questions differently. Third, we surveyed only one member of each institution, whose assessments and judgments may differ from those of the committee as a whole. Fourth, the use of an ethical guideline for dealing with Jehovah's Witnesses may not serve as a valid index for adequate functioning of a committee. Further research is needed in order to develop a scale to assess the efficacy of functioning of a committee. Lastly, respondents will at best provide approximate answers to activity distributions and the like. Although these responses are subject to errors of recall and estimation, they are adequate in providing a current view of ECs in Japan.