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

January 28, 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.

The Consortium’s vision is to serve as a center of excellence in providing leadership in health care ethics education, analysis and practice. The Consortium has worked with its members to address a variety of ethical issues confronted by an increasingly complex health care environment: what is the ethical response to concerns about continuing life-sustaining technology when the question of the medical futility of that treatment has been raised? How do health care professionals provide care that respects cultural, racial and religious diversity? What are the ethical implications of managed care?

A Brief History

The Consortium formally began inviting members in January 1994, but its founding was based on a prior, three-year dialogue with representatives of health care institutions statewide. The dialogue began with a one-year grant awarded by the Georgia Humanities Council in August 1990. Kathy Kinlaw, Associate Director of the Center for Ethics and founding Executive Director of the Consortium, and Dr. Nicolas Fotion, Professor of Philosophy at Emory and member of the first Faculty Board of Advisors for the Center for Ethics, served as co-principal investigators for this grant, leading ethics seminars in hospitals throughout Georgia.

At the conclusion of the grant in September 1991 a statewide symposium on health care ethics was co-sponsored with the Georgia Hospital Association. Dr. John Golenski of the Bioethics Consultation Group in California and Bruce Jennings of the Hastings Center provided keynote addresses. The concept of a statewide partnership was introduced at this conference and participants indicated strong interest in continuing the dialogue and having an educational forum for addressing ethical issues.

During the summer of 1992 three regional meetings were held in Atlanta, Savannah and Albany, involving 75 representatives from health care institutions throughout the state. Participating administrators, medical directors, directors of nursing, and directors of pastoral care affirmed the interest in establishing a Consortium. Myra Christopher, Director of the Midwest Bioethics Center, presented the story of the evolution of her Center.
In early 1993 a written survey was distributed to insure that institutions not represented at the regional meetings provided feedback about possible foci for a statewide network. This planning process identified a desire for general ethics education, assistance in developing and supporting ethics committees (including case consultation and assessment methodologies), end-of-life care education, and discussion about the ethics of allocation of resources.

Beginning in the summer of 1993 a diverse consortium planning group of 30 individuals representing 24 health care institutions began meeting bimonthly. This group of institutions became founding partners of the Consortium and began expanding that membership in January 1994.

Education and Open Dialogue

Though the structure of membership and programming has evolved through the years, the primary emphasis on ethics education and open dialogue and sharing between member organizations continues. A commitment to holding educational programs throughout the state led to the hosting of as many as nine regional meetings each year early in the life of the Consortium.

In recent years, the numbers of meetings has decreased (average of four), but these meetings continue to be held throughout the state and attract participants from beyond the host region. In 2002 the Consortium introduced a one-day, intensive ethics committee workshop both for orientation of new ethics committee members and for in-depth review for those with prior experience in ethics. With a capped registration, interest in the workshop has led to the Consortium’s hosting this event twice yearly. The Consortium also holds an annual statewide conference examining current ethical challenges in health care.

The Consortium now publishes a newsletter twice annually, provides members with a directory of institutional member representatives, maintains a video library of Consortium speakers, and provides ongoing communication of events through its website.

Research and Analysis

The Consortium provides an important structure for research and analysis of ethical issues in clinical and organizational ethics. For example:

A. In 1997 the Consortium published a report from its statewide Task Force on Medical Futility, providing guidance on a proactive approach to avoiding impasses between health team members and family members when concerns about continuing aggressive life support are encountered. The report did not recommend a process for resolving individual patient cases when proactive efforts fail. This question is now being raised again by Consortium members and health care professionals in the state, inviting the Consortium to develop a process to explore the topic of medical futility again.

B. With support from the Whitehead Foundation, the Consortium conducted a survey of member organizations in 1999 and 2000 to determine current end-of-life practices in Georgia. The questionnaire included information about advance directives, pain assessment and management, family support, palliative care, do-not-resuscitate orders, and hastened death. Survey results were published.

C. The Ethics Consortium continued to partner with multiple state organizations on improving end-of-life care, serving as one of the lead organizations in the Georgia Collaborative to Improve End-of-Life Care. With partners in this Collaborative the Consortium has made an impact in such areas as public engagement, health care professional education, and pediatric end-of-life care. During the summer of 2000 the Collaborative worked with Georgia Public Television on the production of Final Choices, a documentary on Georgia efforts to improve end of life care. This program was broadcast with the national PBS series entitled On Our Own Terms: Moyers on Dying, and won several broadcasting awards.

Resources

The Ethics Consortium has benefited throughout these ten years from the affiliation with and in-kind support of the Center for Ethics. Because of the Consortium’s commitment to encouraging participation from all interested organizations, membership fees have been moderate. The Center’s support for the Consortium has been essential to sustaining the Consortium’s work.
Over the years the Consortium has been able to grow in staff size beyond the Executive Director position (Kinlaw) and has benefited from the creativity of several wonderful assistant administrators such as Elizabeth Christian, Lane Busby McLelland, and our current Assistant Director, Karen Trotochaud. The Consortium’s operations would not be possible without our talented administrative assistant, Kim Gardner, who provides registration, membership database, and website management among her many responsibilities, and Windy Clement, who serves as the Consortium’s business manager.

The Consortium has an active Advisory Board composed of health care professionals and administrators as well as community business leaders outside of health care. The Board’s counsel and active involvement in Consortium’s programs and projects continues to be invaluable in the strategic growth of the organization.

The Health Care Ethics Consortium of Georgia is a unique place where research and theory intersect with practice, making “ethics in action” possible.

[ Posted by Kathy Kinlaw at January 28, 2004 03:29 PM |