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.

John Banja interviews himself on his book "Medical Errors and Medical Narcissism"

Question: So why the interview with yourself?

Answer: Because I not only know the best questions to ask, I also know the answers. Plus, interviewing yourself is a great way to control the interview.

Question: It’s kind of narcissistic, though.

Answer: True, but that doesn’t mean it’s psychologically unhealthy.

Question: Well, maybe we’ll discuss that later. With a title like “Medical Errors and Medical Narcissism,” do you think any doctors will read the book?

Answer: Well, some will be turned off by the title. But I tried the title out on dozens of physicians as I was writing the book, and I was heartened by a fairly consistent reaction, which was their eyebrows ascending on their foreheads and their saying, “Interesting …” A few looked at me crossly, though, and said, “What’s your evidence?”

Question: That’s a good question. What is your evidence? In fact, what is the claim you’re making in this book, that physicians are pathological narcissists?

Answer: No, I’m not saying that and I make repeated attempts in the book to remind the reader that I am not making that claim. The claim I really want to make is that medical training, in fact healthcare training in general, has lots of narcissistic traps or temptations for trainees to succumb to.

Question: Like what?

Feb 17 | New Ethical Issues at the End of Life

Daniel P. Sulmasy, OFM, MD, PhD, will speak 4-6pm Feb 17 on "Sedation, Hydration, and Alimentation: New Ethical Issues at the End of Life" as part of the Interdisciplinary Program in Bioethics. The lecture will be in the Rita Anne Rollins Room, 8th Floor, School of Public Health.

This Visiting Scholar Lecture is jointly sponsored by Emory University Health Sciences and the Center for Ethics.

Sulmasy is Chair of the John J. Conley Department of Ethics, Saint Vincents Hospital and Medical Center, and Director of the Bioethics Institute at New York Medical College.

Center receives major grant for joint program with Woodruff Health Sciences

By Kathy Kinlaw, Arri Eisen, John Banja. Center for Ethics faculty focusing in bioethics are pleased to announce a two-year grant of $250,000 from the Woodruff Health Sciences Center Fund to support the deepening of our work in bioethics. The grant allows us to create a new collaborative model through a Program in Bioethics in which the Center for Ethics and the Woodruff Health Sciences Center are key partners.

Kinlaw joins CDC’s flu shot ethics team

By Hillary Winn. The Centers for Disease Control and Prevention has asked four ethicists, including Emory Center for Ethics Director Kathleen Kinlaw, to aid in the development guidelines to determine who should and should not be given the flu vaccine in light of the recent shortage.

The ethicists, who have already discussed the issue over two conference telephone calls, will try to develop an ethical framework for distribution.

Though the CDC will make the ultimate decision, the ethicists will discuss whether or not there are any ethical “lessons that can be applied to this practical question,” said Kinlaw, who is also the director of the Center for Ethics’ program in health sciences ethics.

New film teaches health professionals the art of disclosing medical errors

A videotape entitled “Discussing Unanticipated Outcomes and Disclosing Medical Errors” was recently completed and made available to hospitals throughout the state.

The video was written and directed by John Banja, an Associate Professor at Emory University’s Center for Ethics, and is one of the products of grant #1U18HS11918-01 that was awarded to the Georgia Hospital Association Research and Education Foundation by the Agency for Healthcare Research and Quality in 2001.

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.

April 20 | When Doctors Make Mistakes

The Southern Institute for Business and Professional Ethics' next Executive Breakfast Forum will examine the legal and moral questions confronting doctors and patients when medical errors occur. The speaker will be Dr. John Banja, medical ethicist at Emory University and one of the nation's leading authorities on the problem of medical error--how frequently it occurs, the consequences for patients, and the issues facing physicians regarding disclosure of errors.

7:30am, April 20 at the Capital City Club, Atlanta. Registration required. Conducted in cooperation with the Center for Ethics.

April 9 | Genetically Modified Organisms: Our Genes, Our Future

Award winning geneticist, environmentalist, and educator David Suzuki, Nat C. Robertson Distinguished Professor in Science & Society, will participate in a symposium 10am to 3pm, April 9 in Cox Hall Ballroom. The symposium also features Steven Stice, University of Georgia cloning expert and biotech entrepreneur; Sam Dryden, CEO, Emergent Genetics, Inc.; and Sherry Knowles, intellectual property lawyer.

The event is free and open to the public but reservations are required.

Caring Ethics at the End of Life: Crafting Ethical Guidelines for Research at the End of Life

Join leading ethicists from around the country for a free in-depth discussion on the ethical questions raised regarding research with the nearly dead and newly dead. Friday, February 20, 2004 from 8am to 1pm. Cox Hall Ballroom, Emory University.

For more information, visit the Winship Cancer Institute or call (404) 778-5682.

[ Posted by Chance Hunter on February 02, 2004 | Permanent Link | Comments (1) ]

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.

End-of-life decision making for children: Supporting the needs of parents

When a child is diagnosed with a life limiting illness or condition, his/her parents are thrown into one of the most painful and confusing times a family can face. Not only must they quickly learn about complex diagnoses and confusing treatment options, but they must also deal with the potential death of their child. Unfortunately, there are few resources to which a parent of a child diagnosed with a life limiting illness can turn.

Kinlaw featured in Atlanta Business Journal profile

Center for Ethics Associate Director Kathy Kinlaw was featured recently in an Atlanta Business Journal feature article.

New funding, appointments in health science ethics

Three exciting announcements with our work in health care ethics:

1. Kathy Kinlaw and Karen Trotochaud received funding with Dr. Pamela Bachanas, Psychiatry, and Dr. Nicolas Krawiecki, Pediatrics, to develop and pilot test an advance care planning guide for health care professionals and families of children with life-limiting illness. The funding begins in October 2003. We believe this work will provide a unique contribution to national efforts in palliative and end of life care for children. The grant is award by the Emory Medical Care Foundation.

2. Rallying Points, a program of the national RWJ Last Acts coaltion, has awarded a grant to fund strategic planning for the statewide work in End of Life Care, of which the Center is a lead partner in a statewide partnership of organizations committed to improving end-of-life care. The Rallying Points certificate will bring Dr. Dan Tobin, from the Life Institute in Albany, NY and Kathy Brandt, from the Hospice of the Florida Suncoast, to Georgia to work with our statewide partnership in determining strategic direction for our effort in the state. Dr. Tobin's emphasis is on integrating end of life care conversations into mainstream medicine.

3. Kathy Kinlaw has been appointed to the National Institute of Child Health and Human Development’s Committee on Ethics and Genetics. Kinlaw will serve as a part of a new committee addressing Genomics and Ethics for the National Institute of Child Health and Human Development. In this role she will work with other ethicists in reviewing documents and proposals to the Institute.

Disclosing medical error: August 28

The next meeting of the Clinical Ethics Faculty Seminar is entitled "Disclosing Medical Error: Obscurities, Fears, Ethical Obligations, and the Future." Presented by John Banja, PhD, Clinical Ethicis, Center for Ethics; and Associate Professor, Rehabilitation Medicine.

Thursday, August 28, 2003, 3:30-5pm. Rollins School of Public Health, 1518 Clifton Road, Conference Room 864.

We hope that you join us. Please notify other faculty who may be interested in this topic. The Clinical Ethics Faculty Seminar is hosted by the Quality of Life Program of the Emory University Center for Ethics and School of Medicine.

Marian Osborne at (404) 727-5048 or mosborne@learnlink.emory.edu.

Neuroethics:
A report of the 2003 faculty ethics seminar

By John Banja. Over the last decade the Center for Ethics has hosted a yearly faculty seminar around a theme of ethical interest. In years past, the seminars has featured topics like “Stem Cells and Genetic Technologies,” “Teaching Ethics,” and “The Ethics of Professionalism.” This year’s seminar—which occurred from May 14 to May 23 and was attended by 18 faculty—focused on neuroethics, that is, the recent contributions of the brain sciences to our knowledge of the nature of moral reasoning and moral behavior. In what follows, I’ll give a snapshot view of a few of the prominent issues that were studied and debated.

One of the most provocative approaches to studying moral reasoning has been through the use of magnetic resonance imaging, wherein the brain activity of human participants is captured while they are in the process of contemplating moral issues and dilemmas. This research has debunked one of the oldest moral observations around: that moral deliberation ought to be absolutely purified of one’s sentiments, passions, and emotions and be based on pure, emotionally detached reason alone.

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.

Apology, forgiveness, and disclosing medical error

Consider the following hypotheses: (1) When health professionals realize they have committed a serious, harm-causing error, their feelings of humiliation, betrayal of the patient, and fear of lawsuit can be so unbearable that many will resort to all sorts of conscious and unconscious strategies to diminish or eliminate the emotional pain they are experiencing; and (2) When individuals who have gone for health care strongly suspect that they have been seriously harmed by a medical mistake, they will often experience intense feelings of bewilderment, sadness, and anger. If these feelings are not addressed, they can easily escalate into sadistic rage.

Making a Medical Decision

The next meeting of the Clinical Ethics Faculty Seminar entitled:

"Making a Medical Decision: Patient Preferences, Informed Consent, and the
Patient-Doctor Relationship"

Neuroethics: Summer 2003 faculty seminar

This year’s Faculty Ethics Seminar theme is “Neuroethics.” We wish to bring together neuroscientists who have an interest in ethics, and persons with considerable background in ethics who have an interest in neuroscience.

The seminar this year will begin Wednesday, May 14 and proceed through the following week (there are eight sessions in all). Each daily session lasts three hours, and we alternate mornings and afternoons. Participants usually number about 15.

American medicine: A profession or a business?

Medical ethics has long been associated with the investigation of moral questions arising at the two boundaries of human existence. We have long studied end-of-life dilemmas as well as issues in neonatal intensive care units. A very small portion of the human lifespan is spent in the birthing and dying process, yet medical ethicists and educators continue to focus much of their attention there. What lies in between is ripe territory for further ethical attention and deliberation.

Stem cells and genetics: the 2002 Summer Faculty Seminar

Does a virtually invisible blob of genetic material in a Petri dish count as a constitutionally protected person? Who owns that material when it has been created in a laboratory from donor sperm and eggs? Ought America's government withhold research funds from scientists who want to use those biological materials (which are only going to be discarded anyway), when the benefits of such research can be astonishingly great? Are there some forms of scientific research that simply ought not be done? How do we determine when research participants are being exposed to an excessive amount of risk by certain experiments? What does one generation of human beings owe the next?

Banja awarded grant, appointed to case management commission

John Banja was recently notified that a grant application he helped prepare will be funded by the Agency For Health Care Research and Quality. The grant was awarded to the Georgia Hospital Association, which subcontracted its implementation (as well as the original writing) to the Kerr L. White Institute for Health Services Research.

The science & ethics of stem cell research

Over the last year published reports on the successful culturing of human embryonic stem cell lines have raised new ethical questions. Human pluripotent stem cells, which are capable of developing into multiple specialized cells and tissues, hold the promise of developing therapies for a variety of diseases and injuries. The promise of this therapy has been based on isolation of stem cells from the early stage of the embryo. Controversial sources for current stem cell lines include “excess” embryos at fertility clinics (those which will be destroyed) and fetal tissue from terminated pregnancies.

Moral courage in medicine: disclosing medical error

Although health providers have openly acknowledged and studied the occurrence of medical error over the last two decades, the Institute of Medicine’s year 2000 report To Err is Human captured the public’s attention and concern in an unprecedented way. Claiming that between 44,000 to 98,000 deaths are caused by medical error each year, the study noted how unfavorably health care errors compared with those occurring in other industries, especially the airlines.

If I Should Die Before I Wake

A woman accompanies her husband to the emergency room after calling 911. It is 11:30 p.m. when they arrive - over two hours have passed since she began noticing the frightening signs of a stroke in progress. She had found her husband unable to speak clearly, his face sagging slightly on the right side, and his right arm weakened. She will have to make decisions rapidly now. Has too much time passed or is he still a candidate for administration of TPA? And if he is, will this have the desired effect of dissipating the clot and allowing for return of functioning or will it lead to further bleeding? If the effects of the stroke are severe, how much medical intervention does she want? Should the patient be a "do not resuscitate" patient? Does she know what her husband would want under these circumstances?