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The Challenge of Patients Who Refuse Recommended Management: An Ethically-Grounded, Practical Approach
Joseph Carrese
Dr. Carresse identifies the core ethical tension involved when patients refuse what is recommended; examines the possible reasons why patients might do this; and proposes a systematic, ethically-grounded and practical approach for assessing and responding to patient refusal of recommended management.
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Far from Home and Facing Serious Illness: Palliative Care for Undocumented Immigrants
Anne Kinderman
In this interactive session, participants explore case examples to identify the common issues that arise in the care of undocumented immigrants and the ways that the interdisciplinary health care team can address them. The session also covers the unique losses and sense of isolation experienced by undocumented immigrants, as well as the ethical dilemmas faced by the providers who care for them.
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Caring for Homeless Patients with Progressive Illness
Anne Kinderman and Meg Mullin
Homeless persons with serious illness face unique challenges. Through the lens of real patients' stories, Drs. Kinderman and Mullin give best practices in palliative care for homeless persons and practical tools to improve the care provided to these patients.
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Must We be Morally Courageous in Patient Care
Ann Hamric
This presentation explores courage in health care providers. Dr. Hamric describes a typology of courage that distinguishes between requisite and heroic courage. Arguing the need for a more nuanced understanding of this virtue, and through the lens of clinical examples, Dr. Hamric provides a spectrum of perspectives regarding courage in health care professionals.
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Evolution of Palliative Care: What All Providers Need to Know
Michael Rabow
All clinicians and health care leaders must understand the role and potential of palliative care to help achieve high-value care for patients in the context of fiscal constraints. This address describes in the current state and future of the field of palliative care and its larger role within the ongoing heath care revolution in the United States.
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Palliative Care of the Soul
Michael Rabow
Clinicians must wrestle with their roles and responsibilites in relationship to patients' existential and spiritual distress while sustaining and growing their ability to be of service in the context of patient suffering. This talk describes a vision for the clinician-patient relationship in the context of spiritual challenges and distress.
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Can Reality Match the Rhetoric? Rethinking Social Determinants for Health
Michael Rozier
Caregivers are increasingly expected to attend to the social determinants of health—a patient's education level, housing, food security, social support, access to technology and much more. Addressing the social context of a patient when medical care is delivered holds great promise, but there are also many challenges to doing it well.
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When Populations Become the Patient: A New Ethic for Health Care
Michael Rozier
Developments in health care call on us to serve not only the individual patient but also patient populations. How might we think about the ethical conflicts between individual patient care and population health? What is the potential role of the individual provider and the organization? This presentation includes suggestions on how individuals and organizations can best contribute to this changing landscape.
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From Detached Concern to Empathy: Humanizing Medical Practice
Jodi Halpern
Clinical empathy is central to providing effective and ethical medical care. Dr. Halpern shows evidence that specific components of clinical empathy improves patient satisfaction and medical care.
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Groupthink and Caregivers' Projections: Addressing Barriers to Empathy
Jodi Halpern
"Groupthink," in which team members have reasons to share group mis-perceptions and collectively misread patients, is not a problem of lack of caring, but rather difficulty in maintaining perspective during a conflict. Dr. Halpern shares how reflective self-awareness and empathic curiosity can help overcome such challenges and improve patient care.
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Compassion Fatigue, Caregiver Burnout and the Balanced Life
Carol Taylor
As we seek to maximize health outcomes and productivity while keeping costs down, we risk compassion fatigue. Carol Taylor, PhD, RN, looks at the work-family-leisure balance in caregiver's life, and who they are becoming by the choices they make every day about where and how to spend their time, energy and money.
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Give it More Time: The Ethics of Waiting
Carol Taylor
It's challenging to know when, why and how to deal with delayed decision-making in clinical care. Dr. Taylor uses case studies to explore this ethically-complex issue, and makes practical suggestions about how to manage delayed decision-making when it is no longer appropriate to "give it more time."
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Connecting Ourselves as Health Care Professionals: Mindful Approaches to One Planet Thriving
Donal MacCoon
The importance of sustainability, justice and compassion to the health profession emerges with the goal of "one planet thriving" - sustaining ourselves on one planet's worth of resources.
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Faithful Practice Key Questions at the Intersection of Religion and Medicine
Farr Curlin
Health care professionals are often told they should keep their personal values, and particularly their religious faith, from interfering with their professional practices. In this session, Dr. Curlin reviews his own experiences as a physician to describe four key questions that emerge at the intersection of religion and medicine.
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Why Conscientious Practices and Refusals are Essential to Good Doctor - Patient Relationships
Farr Curlin
What should a clinician do when a patient asks for a legal medical intervention to which the physician has a religious or other moral objection? There is much debate as to whether or not it is ethical for the clinician to refuse what the patient seeks. Do such refusals impose a physician’s personal values on what should be strictly professional decisions?
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Navigating Health Care With a Moral Compass Using Professional Codes of Ethics and Moral Reasoning
Barbara Bennett Jacobs
This interactive, case-based forum explores ways to help professionals manage conflicts between their personal values and the values held by their profession. What are the advantages and disadvantages of professional codes of ethics? How can moral reasoning and ethical theory be helpful? What kind of moral compass should a professional keep in his or her pocket?
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Ethical Challenges in the Use, Abuse, and Addiction to Drugs
Nicholas Kockler
Providing care for patients who fail to cooperate with medical advice can be both challenging and controversial. Dr. Kockler explores the ethical challenges of sustaining therapeutic relationships with patients who use, abuse, and are addicted to drugs. He examines selected cases and gives attention to how ethics consultation might assess different approaches to caring for these patients.
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First do No Harm Optimizing Quality for Frail Elderly and Their Families in the Final Months of Life
Marian Hodges
The frail elderly in their final months of life pose many challenges for their caregivers and health care providers. Dr. Hodges emphasizes the milestones in this ministry and the potential missed opportunities to care the the patient as well as the clinican.
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Cultural Dimensions of Death and Dying
Barbara Koenig
Numerous articles offer council to health care professionals who care for patients from unfamiliar cultural backgrounds.What is best strategy for thinking about culture and engaging in cultural interpretation? How can we avoid stereotyping? Patients near the end of life present profound challenges to our most basic assumptions about appropriate care. Careful, critical reflection, including turning a cultural lens on biomedicine itself is paramount.
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Personal Integrity in the Medical Professions
Margaret Mohrmann
Dr. Mohrmann explains the derivations and multiple meanings of "integrity" while discussing the "paradox" of integrity: that it implies consistency but is always being reshaped. She uses stories from her experience as a pediatrician to demonstrate some of the challenges to personal integrity that can arise in practice.
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Deception and Placebo in Patient Management
John Tuohey
Dr. Tuohey examines the research about placebo use and looks at arguments about their usefulness in a therapeutic setting.
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Are Caregivers Prophetic Leaders A New Look at a Very Old Idea
John Tuohey
Fr. Tuohey uses art along with biblical and historical accounts, to explore what it means to be prophetic leaders in health care. Is it possible that each caregiver can be prophetic leaders without being in charge or takin center stage on some issues?
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Disparities in Health Care: Is Ethics Part of the Problem
Mark Repenshek
Examination of ethics is uncritically influenced by dominant cultural perspectives and the need for health care ethics to be open to multicultural inluences of right and just delivery of health care.
Providence Center for Health Care Ethics manages three funded lectureships, as well as the Andy & Bev Honzel Endowed Chair in Health Care Ethics Lecture, and Core Curriculum III: Special Topics in Health Care Ethics. Our collection addresses ethical issues in health care, issues in palliative care, and humanities in health care.
These presentations contain views that are those of the speaker and not necessarily those of Providence Center for Health Care Ethics.
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