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7:15am – 8:00am
8:00am – 8:15am
8:15am – 9:00am
Dealing with Parents Who Make Decisions Without Having Their Child’s Best Interest in Mind
Parents have the authority and responsibility to make medical decisions on behalf of their children. However, when parental decision making is not in the best interest of the child, clinical practitioners have an ethical and legal duty to challenge parents to advocate for the best interests of their patient, particularly when dealing with critically ill children. Topics to be discussed include the following:
- Examples of decisions which can place a child at harm
- Leveraging strategic post-acute positioning to maximize bundled payments
- Should children be involved in medical decisions regardless of the wishes of their parents?
- Circumstances where minors can make medical decisions for themselves
- The Charlie Gard Case
- Providing hope with the use of experimental treatments
- Ability of patients to purchase whichever treatments they can afford
- Must governments play a regulatory role in protecting patients, regardless of the patient’s desire or ability to pay?
9:00am – 9:45am
Ethical Issues Related to the Care of Nursing Home Patients in the Emergency Room
Medical emergencies are inevitable in most nursing home settings causing patients to be brought to the emergency room. These patients provide unique medical and ethical challenges for emergency room practitioners as they may not have all the pertinent information required to make the proper medical assessment. As such, prompt clinical decisions are needed which may challenge certain ethical principles for which there is not always an easy answer. This session will focus on the many factors considered when deciding on the proper care for nursing home residents (desired level of care, fear of patients passing away in the nursing home, advance directives and potential cost savings) as well as methods for emergency room practitioners to properly deal with these patients.
9:45am – 10:15am
Morning Networking & Refreshments Break
10:15am – 11:00am
Understanding Palliative and Hospice Care - Pushing Patients into Ineffective Treatments
There are a wide range of medical issues and ethical dilemmas that arise in the provision of palliative and hospice care of patients for which it is determined that a cure is impossible. A good understanding of medical ethics will impact a health professional’s decision making for these patients. Regardless of financial constraints, patients should be fully aware that palliative care and hospice alternatives are available, including the possibility that the reduction of pain and suffering may reduce the patient's life.
Multidisciplinary interventions should be sought including specialty consultation, hospice care, pastoral support, family counseling, and other modalities. Patients near the end of life must continue to receive emotional support, comfort care, adequate pain control, respect for patient autonomy, and good communication.
11:00am – 11:45am
The Ethical Dilemma of Balancing Pain Management and Prescription Drug Addiction
Doctors have struggled to find the proper balance between treating pain while avoiding addiction with their patients. While physicians have an ethical obligation to relieve their patient’s pain, they also need to be cognizant of limiting preventable harm when prescribing pain medication. Since prescription drug addiction has become a rapidly growing problem, doctors are reluctant to prescribe narcotic painkillers fearing that the patients will develop an irreversible addiction to the drugs. This may lead to pain treatment being managed sub-optimally. This session will discuss best practices to achieve an ethical balance for opioid prescribing practices while applying the ethical principles of beneficence, respect for autonomy and justice.
Ethical Issues Concerning the Relationship Between Medical Practitioners and the Pharmaceutical Industry
Both medical practitioners and the pharmaceutical industry work towards the treatment of disease and research directed towards improvements in treatment. While their goals are often similar, they also conflict since medical practitioners answer to patients and pharmaceutical companies answer to shareholders. Associations between the pharmaceutical industry and doctors may compromise a health care provider’s professional objectivity and integrity or undermine their fundamental ethical commitment to putting the interests of their patients first. The information the pharmaceutical reps present or gifts provided will most likely bias clinicians in favor of the drug or equipment that is being promoted. This session will review the ethical risks of compromising relationships with patients when dealing with outside market forces, such as physician’s financial interests, insurance and pharmaceutical companies as well as outline strategies to avoid such conflicts of interests.
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