Blog RSS Blog.

02/01/2016

America’s (3D Printed) Gun Problem

by Amanda Zink, J.D.

Last week, Facebook and Instagram banned gun sales on their platforms. Despite the outcry after each mass shooting, believe it or not, America’s gun problem is only getting worse. Since the year 2000, 500,000 Americans have lost their lives to bullets, and over a million more were injured by guns. Mass shootings now occur within our borders DAILY and a child or teen is shot to death about every 3 hours. Eighty percent of the mass shootings in the world between 2000-2014 were in America. The rest of the world thinks we’ve gone mad.…

Full Article

This entry was posted in Uncategorized. Posted by Bonsai Klugman. Bookmark the permalink.

02/01/2016

TOUGH CASES: Code of Ethics Now Available for Healthcare Ethics Consultants

Tarris Rosell, PhD, DMin    
Consider the following hypothetical case scenarios:

Case #1

Jessica, APN, is a member of the Hospital Ethics Committee and serves also on the HEC’s ethics consultation team. Each week, one of eight volunteer consultants takes first call on the dedicated Ethics pager. Two other team members serve as back up to the on-call ethics consultant. 

One day, a consult request is forwarded to the Ethics pager, which Jessica is carrying. It involves a patient on the Medical ICU where Jessica is also a nurse manager. She knows the patient and family, and is all too aware of their conflicted situation with hospital staff regarding goals of care. Jessica also supervises the nursing staff, which rotates care duties on Patient Joe so as not to get too burned out, given his dementia-related raging and flailing. As Jessica reads the ethics consult order, she feels conflicted about her multiple roles in this challenging situation. She wants to be of assistance for ethics, but isn’t certain that she can do so without confusion about what “hat” she’s wearing up on the unit.

What ought Jessica to do, and how would she know?

Case #2

Jonathan, PhD, is taking first call on the Ethics pager this week. One of three consult requests received involves a very messy situation involving a difficult discharge. The 56 -year old female patient, Helen, is homeless and had come to the emergency department weeks earlier in a police cruiser.

At the point when she becomes medically stable, a dilemma is encountered. How could we safely discharge this patient back to the street where she insists on going “if,” as she says, “you won’t let me stay here?” It’s cold outside, and Helen is barely ambulatory, with some signs of dementia. Follow-up self-care would require daily insulin injections and finger sticks for glucose monitoring. While the patient claims ability to do so, the attending isn’t convinced. 

Ethics is consulted, and Jonathan convenes a multi-disciplinary care meeting, including the patient. Consensus eventually is reached on a discharge plan. Helen agrees to go to a homeless shelter with a clinic. 

However, after leaving the hospital, the cab driver lets her off at a downtown intersection instead, as directed by his rider. It is a blustery and frigid winter day. Helen is wearing the thin autumn coat and sandals she had been wearing upon admission. A newspaper journalist happens to stop at the intersection where Helen stands shivering, and notes her hospital bracelet. He rolls down the window and asks if Helen is okay. She mutters that City Hospital left her off here to die. The journalist calls 911, and then makes a call to the hospital operator asking to speak with someone in Ethics. 

When Jonathan receives this page and phone call, what should he say, or not say, to the journalist, and how would he know?

Code of Ethics 

Ethics consultation, like any other professional practice in healthcare, requires professionalism of the consultant. Ethics consultants can either help or hurt those who request assistance. Sometimes even life and death hang in the balance, especially when it is unclear as to which of those two options would be the worse outcome for a critically ill patient. Always there is confidential information to be handled with care and in compliance with HIPAA rules. 

Ethics professionalism matters.

Until recently, healthcare ethics consultants familiarized themselves with the codes of ethics pertaining to other professions, but had none of their own. Jessica and Jonathan might have discerned successfully what they ought to do about their professional ethics dilemmas in the scenarios described. Now their decisions may also be guided by a code of ethics and responsibilities drafted specifically for healthcare ethics consultants.

The American Society for Bioethics and Humanities has posted A Code of Ethics and Professional Responsibilities for Healthcare Ethics Consultants as a downloadable document at http://asbh.org/publications/books. The document lists seven ethical responsibilities for healthcare ethics consultation (HCEC):

1. Be competent.
2. Preserve integrity.
3. Manage conflicts of interest and obligation.
4. Respect privacy and maintain confidentiality.
5. Contribute to the field.
6. Communicate responsibly.
7. Promote just healthcare within HCEC.

Each of these responsibilities is explained in the ASBH document, with illustrative examples provided. 

Applying the Code

In Jessica’s case, she might recuse herself from ethics consultation on grounds of #3, the need to manage conflicts of interest and obligation. One of her back-up consultant colleagues can be called upon to respond instead. 

Jonathan would be guided in his own ethics dilemma by responsibilities #4 and #6 especially, and possibly #7. The probably well-intended journalist may benefit from clarification of the situation with Helen; but any communications with him must be done responsibly, perhaps by a designated hospital spokesperson, and with HIPAA-protected privacy ensured both for the patient and her healthcare providers.

Center for Practical Bioethics personnel contributed to the development and publishing of the ASBH Code of Ethics and Professional Responsibilities for Healthcare Ethics Consultants. It is currently being utilized in hospitals in Kansas City and elsewhere for professional performance improvement toward the goal of excellence in ethics consultation.


Tarris Rosell, PhD, DMin, is the Rosemary Flanigan Chair at the Center for Practical Bioethics. He also serves as Co-Chair of the Hospital Ethics Committee and Director of the Ethics Consultation Team at the University of Kansas Hospital.

Full Article

02/01/2016

Boston’s Fine Arts Museum Offers Doctors Time for Reflection [EOL in Art 197]

Doctors and nurses at Boston’s Brigham and Women’s Hospital are honing their communication and teamwork skills in an unexpected environment: an art museum.


Full Article

This entry was posted in Health Care and tagged , . Posted by Thaddeus Mason Pope, JD, PhD. Bookmark the permalink.

02/01/2016

Bioethics and A Recent Trip to Cuba

Two weeks ago, I had the opportunity to travel to Havana, Cuba and speak with people interested in the topic of bioethics. Los Pinos Nuevos, a Protestant denomination with over 400 churches throughout the country, invited my wife and me to participate in discussions on bioethics over three days with up to twenty people involved in the educational activities of the denomination. I have been... // Read More »

Full Article

This entry was posted in Health Care and tagged , . Posted by Neil Skjoldal. Bookmark the permalink.

01/31/2016

Jahi McMath – Update on the Malpractice Litigation

On Friday, January 29,  the Alameda County Superior Court held a brief hearing on the medical defendants' demurrers to the McMath family's first amended medical malpractice complaint.   As he indicated in prior rulings on similar motions, Ju...

Full Article

This entry was posted in Health Care and tagged , . Posted by Thaddeus Mason Pope, JD, PhD. Bookmark the permalink.

01/30/2016

Brand New Futile Care Fellowship Created

"Futile care has finally blossomed into its own branch of medicine."  Check out this clever, funny, and too true post at Gomer Blog.

Full Article

This entry was posted in Health Care and tagged , . Posted by Thaddeus Mason Pope, JD, PhD. Bookmark the permalink.

01/29/2016

I had to laugh…

I had to laugh. A recent article in Annals of Internal Medicine describes an experiment to determine the “safety and behavioral effect” of disclosing to subjects the pleiotropic effect of the APOE genotype. Pleiotropy describes genes that have more than one effect.  In this case, having the APOE4 version of the gene heightens one’s risk […]

Full Article

This entry was posted in Health Care and tagged , . Posted by denasdavis. Bookmark the permalink.

01/29/2016

Drawing the Human Heart

This video is adapted from a presentation delivered by our Art Editor, Laura Ferguson, at the 2015 conference of the American Society for Bioethics + Humanities.

Full Article

01/29/2016

Responding to Zika: Ethical Challenges of Zoonotic Diseases

Chelsea A. Jack

Full Article

This entry was posted in Health Care and tagged . Posted by Laura Haupt. Bookmark the permalink.

01/29/2016

Minnesota Compassionate Care Act (Jan. 30, 2016)

Come to the new Senate Building tomorrow to discuss the Minnesota Compassionate Care Act.  Medical aid in dying may be coming to Minnesota.

Full Article

This entry was posted in Health Care and tagged , . Posted by Thaddeus Mason Pope, JD, PhD. Bookmark the permalink.