Reminder: Disaster Ethics Symposium and Forum December 7

The Perfect Storm: Disaster Ethics Symposium and Public Forum

Wednesday, December 7, 2011

Kansas City Public Library – Plaza Branch
Truman Forum Auditorium
4801 Main Street
Kansas City, Missouri 64112

The Center for Practical Bioethics is hosting a symposium and forum on the ethics of disasters on December 7 at the Kansas City Public Library-Plaza Branch. The symposium features presentations by medical professionals who were on the scene during the Hyatt Hotel disaster in Kansas City, Hurricane Katrina in New Orleans, and the tornado that ripped through Joplin, Missouri in May 2011.

Continuing education credits are available for the symposium.

At 5 pm that evening, a public forum is scheduled with Anna Pou, MD, who spent nearly a week in Memorial Hospital in New Orleans after Hurricane Katrina hit in 2005. A responder panel will follow Dr. Pou’s remarks. Registration for the public forum is $15.

· Symposium: 8 am to 4 pm
· Public Forum featuring Dr. Anna Pou and responder panel: 5 pm (New Time!)
· Online Registration

Questions? Contact Cindy Leyland at cleyland@practicalbioethics.org or call 816-979-1357.

Publish Opinions of Hospital Ethics Committees?

Our friend Thaddeus Pope prompted a wide ranging discussion on our end with the suggestion that hospital ethics committees publish their opinions.

Following are the thoughts of Tarris Rosell, PhD, the Rosemary Flanigan Chair at the Center for Practical Bioethics.

L2

Hmm. I can see Thad Pope's point. And there are any number of interesting case consultations on which collegial input might be welcomed.

It is easier to think of publishing (online, listserve, journal) a case that is several years past rather than one current or recent, due to fear of violating privacy even with de-identified data. Feedback on the latter sort (current or recent) likely would be of more value for its freshness and immediate critique, affirmation or accountability.

Yet, I wonder what our HIPAA people and Risk Manager would say about Professor Pope's
suggestion...

By the way, I think there are not a majority of ethics committees that function in a way as to have potentially publishable "committee opinions." Many of our hospitals have consultation services or subcommittees, or else a solo clinical ethics consultant.

The chart notes or emailed responses that are drafted in response to a consultation request typically would not rise to the level of written "opinion" that an attorney like Pope might have in mind. On the other hand, we do write recommendations in the chart oftentimes, and those could well be challenged by peer review--if submitted for such.

Tarris Rosell, PhD, DMin
Rosemary Flanigan Chair
Center for Practical Bioethics

Schedule Change - Disaster Ethics Public Forum

The public forum featuring Anna Pou, MD, scheduled for December 7 at 6 pm, has been changed to 5 pm. A responder panel will focus on Kansas City’s ethical response to a disaster following Dr. Pou’s remarks.

Dr. Pou will speak about the days following Hurricane Katrina when she and two nurses at Memorial Medical Center were arrested and charged with second-degree murder of patients. A grand jury refused to indict any of the three and the case never went to trial.

Local media reports indicated the situation “ignited a furious debate in New Orleans and elsewhere about whether sharp ethical boundaries can be drawn around decisions on patient comfort made in a crisis.’

The Perfect Storm – Disaster Ethics Symposium & Public Forum will begin with the symposium at 8 am at the Plaza Branch of the Kansas City Public Library. The symposium features presentations by medical professionals who were on the scene during the Hyatt Hotel disaster in Kansas City, Hurricane Katrina in New Orleans, and the tornado that ripped through Joplin, Missouri in May 2011.

Continuing education credits are available for the symposium.

Links:

· Overview
· Symposium: 8 am to 4 pm
· Public Forum featuring Dr. Anna Pou: 5 pm
· Online Registration

Defining Decisional Incapacity

Tarris Rosell, DMin, PhD
Rosemary Flanigan Chair
Center for Practical Bioethics

We recently received a request to define limited/partial/diminished decisional capacity and found that such a definition is not as easy as one might think.

There are many definitions available of what it means to have and to assess capacity. The definitional problem is that limited/partial/diminished (and transient) all fall on a spectrum between full and no capacity, and is context/decision specific.

One resource can be found at www.apa.org/pi/aging/.../capacity-psychologist-handbook.pdf. Otherwise I suggest these definitions:

Full decisional capacity means that an individual has sufficient . . .

· knowledge with understanding (of relevant information, including risks and benefits)
· voluntariness without coercion,
· decisionality (ability to choose between options)
· communicability (ability to communicate choices made)

So as to be able to make all types of life decisions for oneself.

Limited, partial, or diminished capacity means that an individual has insufficient knowledge, voluntariness, decisionality, and/or communicability so as not to be able to make some types of life decisions for oneself.

Capacity or incapacity is always in relation to the type of decision to be made. Decisions involving higher risk and/or lower benefit require more sufficiency of knowledge with understanding and voluntariness without coercion. Decisions involving lower risk and/or higher benefit require less sufficiency of knowledge with understanding and voluntariness without coercion.

Decisionally incapacitant means that an individual has insufficient knowledge, voluntariness, decisionality, and/or communicability so as not to be able to make any type of life decision for oneself.

What do you think?

Resuscitate the Slow Code?

John Lantos, MD

Slow codes, defined as half-hearted efforts to resuscitate patients, have been called deceptive, dishonest, unethical and deplorable. But is it time to reconsider that point of view? Can slow codes be appropriate, and ethically defensible?

Dr. John Lantos thinks so and he expresses that point of view in the November 2011 edition of The American Journal of Bioethics. And he talks about it with host Lorell LaBoube of The Bioethics Channel.
Link to podcast here.

Carney appointed President/CEO at Center for

The Center for Practical Bioethics has announced John G. Carney will assume leadership of the Center by January 1, 2012. He replaces the Center’s founding executive, Myra Christopher, as president and chief executive officer.

Carney is a well-known advocate for patients, families and caregivers dealing with chronic and progressive disease. Christopher will continue with the Center as the Kathleen M. Foley Chair for Pain and Palliative Care.

For more click here.

Top 10 - Lectures in Bioethics October 2011

Systems Reform and Innovation, Robert St. Peter, MD
Religion. Healthcare. Do the Twain Meet?, Rosemary Flanigan
The Role of Conscience in Medical Decisions, Daniel Sulmasy,MD
I'm dying STAT! Call my -- lawyer?, Bill Colby, JD
Health care reform needed but comes hard, Steven Schroeder, MD
Chronic Disease and Aging, John Carney
A Physician's Reflections on Bioethics, Robert Potter, MD
Bioethics and the Underserved: Culture, Values and Justice, Richard Payne, MD
Pain is HARD: The Complexity of Pain Treatment and Management, Rollin “Mac” Gallagher, MD
Eugenics, Race and Bioethics, Glenn McGee, PhD

Top 10 - The Bioethics Channel October 2011

Here are links to Top 10 editions of The Bioethics Channel for October 2011.

If you have any ideas for topics and guests please let me know at llaboube@practicalbioethics.org.
Thanks for listening!
Lorell LaBoube
Director of Communications
Center for Practical Bioethics

Top 10 - The Bioethics Channel October 2011
Ethically Dubious: Prisoners and Organ Donations, Art Caplan, PhD
Nurses Treating Pain, Pamela Bennett and Ann Schreier
The State of Altered Consciousness, Joseph Fins, MD
Advance Directives and Medicare Spending, Myra Christopher
Pain and Public Health, Daniel Goldberg, PhD
Avoiding Unwanted Hospitalizations, Sandy Silva
Integrative Pain Treatment, Heather Tick, MD
The Ethics of Donating Eggs, Glenn McGee, PhD
Ashley X Revisited, Norman Fost, MD and John Lantos, MD
Religion and Medicine: Compatible?, Farr Curlin, MD and John Lantos, MD

Disaster Ethics Symposium Dec 7 in Kansas City

Terri Edens, RN, is an emergency room nurse at St. John’s Regional Medical Center in Joplin, MO. On May 22, 2011, she was on duty when a devastating tornado shredded much of the southwest Missouri community.

Edens looks forward to the completion of the hospital’s temporary facility.

“It will be very nice to have more space and solid walls again,” Edens says, “but mainly we look forward to continuing to do the job we love which is serving our community.”

Hear Terri Edens and a host of other medical professionals describe their disaster experiences during The Perfect Storm: Disaster Ethics Symposium and Public Forum on Wednesday, December 7, 2011 in Kansas City.

The symposium features presentations by individuals who were on the scene during the Hyatt Hotel disaster in Kansas City, Hurricane Katrina in New Orleans, and the tornado that ripped through Joplin, Missouri in May 2011.

At 6 pm that evening, a public forum is scheduled with Anna Pou, MD, who spent nearly a week in Memorial Hospital in New Orleans after Hurricane Katrina hit in 2005. Registration for the public forum is $15.

Continuing education credits are available for the symposium.

Links:
Symposium - 8 am to 4 pm
Public Forum featuring Dr. Anna Pou: 6 pm
Online Registration
PDF Flier