Ethicslab Essentials

On March 11, the World Health Organization (WHO) declared COVID-19 a pandemic, pointing to the over 118,000 cases of the coronavirus illness in over 110 countries and territories around the world and the sustained risk of further global spread. To discuss some of the ethical issues regarding COVID-19 we are joined by Dr. Ken Iserson […] The post COVID-19: The Ethical Landscape appeared first on Mission Network.

We hear many stories these days about immigration. Certainly, healthcare workers see undocumented individuals in Emergency Rooms or clinics. What is that experience like of being undocumented and needing healthcare? What would be helpful for clinicians to know? Does healthcare ethics have something to say on this topic? Today we hear from two healthcare leaders […] The post Undocumented Patients: Two Journeys appeared first on Mission Network.

Health disparities and health outcomes for African Americans, is egregious… Regarding pain medication, a 2019 published article offered that the pain of African Americans is systematically under-diagnosed and under-treated Our guests today will offer stories and discuss insights on end of life care in the African American community. Our guests in this episode include: Patrick […] The post End of Life Disparities: The African American Community appeared first on Mission Network.

New research findings regarding HIV status will impact how we understand and practice disclosure of HIV status of patients… specifically whether or not to disclose a sick patients’ HIV serostatus to their family or partner. The new research demonstrates that when an HIV-positive person sticks to their treatment, their HIV is undetectable and untransmittable (U=U). […] The post HIV Disclosure: New Ethical Approaches appeared first on Mission Network.

Consider someone leaving a hospital, after their care is completed at that location, to return to their home and local community. As discharge plans are made to continue their care, their healing, their rehabilitation, are there ethical challenges that arise? Can there be biases that shape that plan because of their ability, disability, lack of […]

Brain death is a fundamental ethical topic that is complex and often fraught with emotion. As ethics committees are faced with considerations involving brain death, these cases are often those that stick with professionals the most. Our lead contributor in this episode Becket Gremmels, System Director of Ethics at CHRISTUS Health in Irving TX is […]

Why would the question of whether to provide food and water to a patient come up at all? One might assume it is always helpful and never harmful to offer nutrition and hydration to patients. Is that accurate? When might it be appropriate or not appropriate? Our lead contributor in this episode is Alan Sanders, […]

Goals of care is a term so common to health care professionals and yet, our guests describe significant clinical experiences in which the lack of discussion around goals of care led to problematic cases. A goals of care conversation is an important element at the foundation of high quality discussions around code status. In this […]

Informed consent is one of the foundational ethical principles in health care that supports patient autonomy, or stated differently, the patients right to self-determination. More and more the standard for what clinicians should inform patients about the risks benefits and alternatives of treatment are no longer determined by what a responsible body of physicians deems […]

The big picture is that 115,000 men, women and children await organ transplants in the United States. Even the largest football stadium in the US could not fit the number of patients on the national transplant waiting list. In 2016, 33,600 transplants brought new life to patients and their families. Since 1988, 683,000 transplants have […]

As patients, surrogate decision makers, and clinicians discuss goals of care, questions arise regarding what interventions will physiologically work and what interventions will honor the patient’s values. Do Not Resuscitate Orders are one of the interventions frequently discussed. Our lead contributor on this episode, Mark Repenshek, Executive Director for Ethics & Mission at Hospital Sisters Health System, in Wisconsin is in conversation with guests to explore a number of ethical issues related to Do Not Resuscitate orders that include, but are not limited to: a) Patient/Surrogate desires for full resuscitation despite the intervention’s lack of efficacy in specific clinical circumstances, b) Consideration of partial codes as a “compromise” co-status, c) A physicians’ professional right to limit the use of resuscitation efforts in certain circumstances. The episode also introduces a new series within the EthicsLab Podcast called EthicsLab Essentials. This new series is designed to be an introductory series o

Have you ever experienced an event, a situation or a decision where you felt that your professional integrity had been compromised? It may have occurred because of something you did, something someone else did or simply a number of events that lined up in a way that made you feel that you were between a rock and hard place. In that moment you probably experienced moral distress. In this episode, we look at moral distress in the health care environment. What are the clinical situations that cause moral distress to arise, what can be done to respond, can it be cured or is it a part of our moral life? Our guests in this episode are: Dr. Cynda Rushton, the Anne and George L. Bunting Professor of Clinical Ethics in the Berman Institute of Bioethics and the School of Nursing at Johns Hopkins University Dr. M. Sara Rosenthal, Ph.D., Professor and Founding Director, Program for Bioethics, Departments of Internal Medicine, Pediatrics and Behavioral Science Chair, Hospital Ethics Committee, University of Kentucky

Health care ethics committees help patients and clinicians with tough choice decisions. Within this work of clinical ethics consultation, what are practical tools being used to improve their competence and impact? In this episode, our guests present such practical tools that help health care ethics committee members become more competent, become more aware of gaps and trends, and have more impact on improving the care and health experience of patients. Our guests in this episode include: Becket Gremmels, PhD, System Director of Ethics, Mission Integration Department. CHRISTUS Health Katherine Wasson, PhD, MPH, Associate Professor, Neiswanger Institute for Bioethics, Stritch School of Medicine, Loyola University Chicago Mark Repenshek, PhD, Executive Director, Ethics & Mission, HSHS Eastern/Western Wisconsin Division, Door County Medical Center Laura J. Bishop, Ph.D, Associate Teaching Professor and Academic Program Manager, Kennedy Institute of Ethics, Georgetown University Additional Resources in

One of the challenging areas in clinical practice today is wanting to honor patient wishes but not being clear on the competency or capacity level a patient with dementia or behavioral health issues. In this episode we explore different challenging situations that ask: a) What is the best assessment of capacity? b) What level of risk should be supported? c) How might health care professionals approach these situations at a deeper human level? Our guests, who are national experts in this area and will offer insight and practical consideration and approaches to the questions list above and others. Our guests in this episode include: Sherri Boggs, Quality, Patient Safety & Education Manager, Our Lady of Peace Hospital Dr. Stephen Post, international speaker, best selling author and the Director for the Center for Medical Humanities, Compassionate Care, and Bioethics at Stony Brook University Dr. Paul S. Appelbaum, New York State Psychiatric Institute and Columbia University Department of Psychiatry Dr.

Health care professionals, patients and family members could all agree that patient wishes about their care are important and need to be respected. Why then, nationally, do only 30 percent of adults have an advance directive that documents those wishes? Given that statistic, how could the town of La Crosse, Wisconsin, achieve the surprising goal that 96% of people who die there have an advance directive or similar documentation…such a difference from the national average? Some wonder how to begin such a conversation while others ask what the best systems to put in place are? Yes, there are better tools, practices and systems that can help us. Our guests in this episode include: Bernard “Bud” Hammes, PhD, Executive Director, Respecting Choices, A Division of C-TAC Innovations David Bailey, Physician ENT and Chief Medical Officer for Memorial Health in Lufkin, TX. Kate (O’Rourke) DeBartolo, National Field Director, Institute for Healthcare Improvement at The Conversation Project Suzanne Engelder, MSW,

Are there better ways to build and support a culture of clinical ethics in healthcare? What might that look like? What has worked and how could the ideas and tools offered be implemented? In the late 1990’s the idea was proposed, why not marry the work being done in health care ethics with quality improvement methodology. Would this type of “Thinking Differently” help us get traction and improve the systems and initiatives that clinical ethics tries to accomplish? These are some of the questions and issues that our guests will wrestle with as well as offering concrete examples and even practical solutions being tested today. Our guests in this episode include: Mark Repenshek, Sr. Director of Ethics, Ascension Health Bob Strickland, Sr. Vice President Performance Management, Catholic Health Initiatives Bob Scheri, Vice President Mission Integration, CHI Memorial