ethics news & views

March 30 | Never Say Die: Vitalism, False Hopes, and Value Conflicts

A Visiting Professor Lecture by Dr. William Winslade, James Wade Rockwell Professor of Philosophy of Medicine, Professor of Preventive Medicine and Community Health and Professor of Psychiatry and Behavioral Sciences.

Date: Wednesday, March 30, 2005
Time: 4:00-6:00
Place: Emory Hospital Auditorium

Vitalism is the view, based on religious or secular values, that a person’s life should be prolonged as long as possible even if the person is terminally ill or permanently unconsciousness. This lecture will explore the psychological, legal, social, and ethical consequences of vitalism in the context of several recent controversial cases.

For more information, please contact Marion Osborne at (404) 727-5048. Sponsored by the Center for Ethics and Emory Health Sciences.

Health Care Consortium Conference is a Hit

The 10th Annual Conference of the Health Care Ethics Consortium of Georgia (HCECG), planned as an exceptional educational event and as a joyous celebration, truly accomplished both. With a dual focus on both the history that serves as the foundation of bioethics and a glimpse of what may face us in the future, the conference, A Decade of Ethics Experience: Looking Back, Looking Forward, held March 31 to April 1, offered a discussion of past successes and failures and speculated on future challenges.

Kinlaw Honored with Inaugural Award

In an surprise announcement Kathy Kinlaw--Executive Director for the Health Care Ethics Consortium of Georgia--was honored with presentation of the first Heroes in Healthcare Ethics Award.

Kinlaw is credited with the initially development of the Health Care Ethics Consortium of Georgia in the early 1990’s. Her work with health care organizations across Georgia and their ethics committees has made her a frequently sought-after speaker and presenter. She is also recognized for her work to further bioethics education for medical students, especially those at Emory University School of Medicine.

Kinlaw was presented with a glass sculpture from Fräbel Studio of Atlanta that was commissioned by HCECG and designed is such a way to suggest holding ethics to the highest standard. The curvature of the three supporting glass rods holding the blue sphere represents the achievement of this highest standard.

The Heroes in Health Care Ethics Award is an annual award to be given to an individual or group associated with an HCECG member organization in recognition of exemplary achievements in the field of health care ethics. The award is underwritten by a gift from King and Spalding.

Imlay Foundation Funds HCECG Website

As the Health Care Ethics Consortium of Georgia has grown from a grass root effort to a larger statewide organization, a need for timely communication and education about health care ethics has increased. Although HCECG has enjoyed a simple website for several years, it has provided us with only one-way communication. Advances in internet technology could provide us with so much more.

HCECG is pleased to announce that it has been awarded a $26,000 grant from the Imlay Foundation to develop its website and information technology. With this grant its hopes to upgrade its website, introduce a members-only feature, provide for online conference registration and membership renewal, improve data analysis, and provide an online discussion board. Implementation is expected by the end of 2004.

Ten years of health care ethics leadership across Georgia: Celebrating the Health Care Ethics Consortium of Georgia

2004 marks the tenth anniversary of the Health Care Ethics Consortium of Georgia. The Consortium is an active partnership of organizations throughout the state, committed to addressing ethical issues that arise in providing health care for patients and families. The Consortium currently includes 74 member organizations – including hospitals, health systems, hospices, long term care communities, home health, rehabilitation centers, and insurers. The Center for Ethics supports the Consortium through office space, partial staff support, and access to ethics resources.

Health care leaders challenged to foster ethical organizations

By Karen Trotochaud. With a strong recommendation for healthcare organizations to conduct an “organizational ethics audit,” Paul Hoffamn, DrPH, from Provenance Health Partners, challenged health care leaders and professionals to move toward an organizational culture of ethics beginning with an assessment of their ethical climate.

Kinlaw to receive Dean's Teaching Award

Center for Ethics' Associate Director Kathy Kinlaw has been chosen by Emory Medical School faculty and staff to receive a Dean's Teaching Award for the academic year 2002-2003. In addition to the honor of being chosen, Kinlaw will receive a $4,500 award.

As Associate Director, Kinlaw heads the Center for Ethics' programs in health science ethics. Kinlaw teaches the third-year School of Medicine course in clinical ethics and directs the Health Care Ethics Consortium of Georgia, a statewide organization for hospitals and health care organizations.

Georgia receives end-of-life care report card

November 18 the Last Acts organization, a national coalition dedicated to improve end of life care, released the report "Means to a Better End: A Report on Dying in America Today". The report is based on indicators chosen by a national panel of experts; indicators included:

• advance care planning,
• the site of where deaths occur,
• utilization of hospice care,
• time spent in intensive care,
• pain management, and
• physician and nurse training.

Each state was rated according to these indicators.

Improving cancer treatment means care for dying patients

One of every two men and one of every three women in Georgia will develop cancer during their lifetime and almost one-half will die from the disease. The Georgia Cancer Coalition, funded by the tobacco settlement money in Georgia, has a goal of increasing cancer research, prevention, early detection and treatment. The Coalition has also made a commitment to those patients who will not be cured.

As a primary partner in the Georgia Collaborative to Improve Care, the Health Care Ethics Consortium of Georgia is working with the Cancer Coalition to address quality of life, palliative care and end of life care in Georgia. Palliative care supports comprehensive care of the cancer patient and family from the point of diagnosis, including relief from symptoms, psychosocial and spiritual support, and support for family through bereavement.

Doing ethics at Emory Hospitals: an interview with CEO John Henry

Kathy Kinlaw and John Banja recently spoke with John Henry, Sr., CEO of Emory Hospitals & Wesley Woods Center.

Question: Does the current nature of health care raise ethical concerns? Are new issues presented or are the ethical concerns ones that have repeated over the years?

John Henry: I still think that the health care ethical concerns deal with rationing of care, and it is a little bit different today then it was ten years ago. Managed care companies decide what is appropriate in dealing with continued treatment; they also are not just managing care but managing payment. If I operate on Mr. Smith on Friday, and he went into the ICU on Friday and spent Saturday and Sunday in the ICU, I can guarantee that one of those ICU days will be denied as not necessary, regardless of the fact that we think that it might have been necessary. Weekend stays are one of the issues.

[ Posted by John Banja on March 01, 2003 | Permanent Link | Comments (1) ]

Medical education on end-of-life care reviewed

In a unique event, representatives of the four medical schools in the state of Georgia came together to jointly review the state of medical education on end-of-life care. Faculty, residents, and medical student representatives from the medical schools of Emory University, Medical College of Georgia, Mercer University, and Morehouse School of Medicine met at the Loudermilk Conference Center in Atlanta on April 23, 2001.

Health Care Ethics Consortium of Georgia grapples with health care harms

A key ethical principle of modern day bioethics is nonmaleficence, defined by Beauchamp and Childress as “the principle that we ought not to inflict evil or harm on others.” Long attributed to Hippocrates, the maxim “above all, do no harm” has long been a fundamental part of the tradition of medical ethics. But what does one do when in the process of intending to be helpful and do good one causes another harm? The Health Care Ethics Consortium of Georgia’s annual conference—“Causing Harm in the Name of Doing Good,” held April 23-24—addressed just this dilemma.

[ Posted by Karen Trotochaud on September 01, 2002 | Permanent Link | Comments (1) ]

Georgia nurses report on end-of-life care practices in Center for Ethics survey

Nurses have long been primary care providers for patients who are dying, providing comfort and caring for patients, supporting grieving families as they struggle through this difficult time, and coordinating aspects of care provided by other healthcare providers. As a part of an interdisciplinary study, Georgia nurses were mailed a survey inquiring about current institutional and individual practices, attitudes, beliefs and experiences in caring for patients at the end of life. The Whitehead Foundation funded this survey as a part of the broader commitment to improve end-of-life care by the Health Care Ethics Consortium of Georgia at the Center for Ethics, in conjunction with the Georgia Collaborative to Improve End-of-Life Care.

Should doctors reveal one another's errors to patients?

A physician told me about a case in which a surgeon left a piece of gauze in his patient's abdomen after a surgery. The gauze was discovered in a subsequent surgery, and the error was noted in the patient's records. The patient, however, was never told about it. Unfortunately, the patient's condition worsened over the next two years, owing to complications that were almost certainly related to the surgical error. During those two years, the patient saw five other physicians, each of whom read his medical records and knew about the error. Yet, those doctors never told the patient. Should they have?

[ Posted by John Banja on May 01, 2002 | Permanent Link | Comments (3) ]

What do Georgia's health care providers think about end-of-life care?

Over 700 healthcare providers completed an eight-page survey on institutional practices and individual practices and attitudes related to end-of-life care. Kathy Kinlaw and Karen Trotochaud– with statistical assistance from Nancy Thompson, PhD and Amy Sandul, MPH from the Rollins School of Public Health—are currently analyzing responses to this survey, mailed out earlier this semester to doctors, nurses, social workers, and healthcare chaplains throughout the state of Georgia.

Ethics consortium hosts annual conference on causing harm in health care

Within the healthcare setting, the ethical principle of First Do No Harm is one of the most frequently quoted tenets. Yet we read the Institute of Medicine’s report on the occurrence of medical errors and frequent news stories about how our health care system has failed to provide quality care for individual patients.

How can this be happening? Surely, healthcare professionals keep the duty to avoid harm foremost and fundamental to the goal of benefiting the patient and the community. In this era of health care, however, it is not always clear when benefit is achieved, when “costs” or burdens to the patient are justified, when burdens or lack of benefit become a harm, and when harm that occurs in the course of care crosses a line and becomes a wrong.

HCECG highlights best medical practices across Georgia

On June 8 the third annual meeting of the Georgia Collaborative to Improve End-of-Life Care, Sustaining the Momentum: Best Practices in Georgia, featured innovative and successful programs that are addressing the needs of patients and their families facing end-of-life care. The keynote address was given by Bud Hammes, PhD, who discussed the remarkable work program focused on community based advance care planning in LaCrosse. (85% of patients who died in hospitals in LaCrosse had completed advance directives (AD), 96% of these patients had AD’s in their patient records, and 98% of the plans were followed. This compares with approximately 15% of patients having AD’s in most other reported studies.)

'Final Choices' wins three national awards, re-airs on public television in August

Final Choices, a documentary on end-of-life experiences by Georgians, produced by the Georgia Collaborative to Improve End of Life Care (of which the Center for Ethics is a lead partner) in conjunction with Georgia Public Television (GPTV), was honored with three awards.

Pediatric End-of-Life Task Force concludes first year, identifies barriers to care

Facing dying children and their families on a daily basis, staff members in an intensive care unit were informally asked if they agreed or disagreed with the statement that there is a reluctance to address end-of-life care issues. An overwhelming number, 88%, responded “yes.”

Initial end-of-life care survey completed, more to follow

In January 2001 End-of-Life Care Practices: A Survey of Organizational Members of the Health Care Ethics Consortium of Georgia was completed. This report summarizes the results of a 130-item questionnaire that was sent to member representatives of HCECG. As a pilot study, these data are extremely valuable in estimating the prevalence of knowledge, attitudes, and beliefs about end-of-life care practices.

Healthcare providers connect at HCECG annual conference

The Health Care Ethics Consortium of Georgia hosted its annual statewide conference, "Ethics in a House Divided: Connecting Decision Makers in Healthcare Organizations," on May 22 and 23, 2001. The goal of the conference was to bring together the many different professionals who are called to address complex problems within healthcare organizations. In attendance were physicians, nurses, social workers, chaplains, administrators, health lawyers, risk managers, case managers, and others from around the state.

Health care professionals surveyed on end-of-life care

“How would you rate your facility’s effectiveness in providing high quality end-of-life care?” was one of the questions asked of representatives of member institutions of the Health Care Ethics Consortium of Georgia as a part of the End-of-Life Care Practices Survey in November. Of the 480 representatives, 101 completed this extensive 130-question survey providing formative information on practices and attitudes of health care providers from various professional disciplines and institutions throughout Georgia.

End-of-life conversation extends to care of children

Through the leadership of the Health Care Ethics Consortium of Georgia, the Center for Ethics in partnership with the Georgia Collaborative to Improve End of Life Care has focused its efforts on identifying obstacles to and opportunities for improving the care of dying adults. With the support of the John H. and Wilhelmina D. Harland Charitable Foundation, the Center for Ethics is extending this conversation to include children at the end of life.