THE SOUL OF BIOETHICS (Feb. 15, 2003) Edited by H.R. Moody - Case Study: Waiting for a Miracle - End of Life Care - Caregiver Burden - Debates on Research, Ethics and Aging - Inner Life of Healers - From Rules to Caring Practices - End-of-Life Certificate Program - Coming Events ====================================================== CASE STUDY: "Waiting for a Miracle" Dr. Jones believed Emma only had a one percent chance of breathing on her own. At 72-years old, Emma was suffering from chronic obstructive pulmonary disease and had been receiving mechanical ventilation for two months because of acute respiratory distress syndrome and multi-organ failure. Despite her grim prognosis, her husband, Richard, expected a healing miracle. Dr. Jones was facing a dilemma. Because patients with this condition often have a poor diagnosis, Dr. Jones began to discuss limiting life-sustaining interventions. However, Richard insisted mechanical ventilation be continued, believing that God would answer their prayers and perform a miracle. Response to the Case Fortunately, Dr. Jones knew about the compelling research on the importance of sensitively addressing patients' spiritual concerns. He began responding with comments and open-ended questions like, 'I can see your faith is very important to you,' and 'Tell me more.' Clarifying Richard's belief in miracles helped Dr. Jones appreciate why the family wanted to continue 'heroic' interventions and clarified how faith was a source of support and hope to this family. By inquiring further, Dr. Jones connected with the family. He was able to align hopes by saying he also hoped for a miracle. Dr. Jones knew that once the family felt that he understood them and cared about Emma they might be more willing to hear his views on prognosis and care. Eventually Richard and Dr. Jones were able to agree on relief of suffering a goal of care. by responding like this, Dr. Jones built a relationship that allowed agreement on specific clinical decisions about ventilation, vasopressors, dialysis, and Cardio Pulmonary Resuscitation (CPR). This case study and the commentary appears in the November, 2002 letter from the International Center for the Integration of Health and Spirituality. For more on the Center and its work, visit: http://www.icihs.org ----------------------<<< >>>------------------------ END OF LIFE CARE "Means to a Better End: A Report on Dying in America Today: State Fact Sheets" has been published by the Last Acts Campaign (November 2002, .pdf format, 95p.). This web site that contains full text also contains summary findings, an interview with the authors, and an interactive state report card. Available at: http://www.rwjf.org/news/featureDetail.jsp?id=44 See "Care of the Dying Patient: The Last Hours or Days of Life," by John Ellershaw and Chris Ward (British Medical Journal, Vol. 326, No. 7379, Jan. 4, 2002, pp. 30-34) available at: http://bmj.com/cgi/content/full/326/7379/30 ----------------------<<< >>>------------------------ CAREGIVER BURDEN An article on ethical dilemmas in "Caregiver Burden" is available on Bioethics.Net, sponsored by the American Journal of Bioethics. See: http://bioethics.net/er_bioethics.php?task=view&articleID=46 ----------------------<<< >>>------------------------ DEBATES ON RESEARCH, ETHICS AND AGING "What are the possibilities and the pitfalls in aging research in the future?" was the subject of a public debate on Feb. 12 between Francis Fukuyama and Ron Bailey, moderated by Morton Kondracke and sponsored by Sage Crossroads. Sage Crossroads is a project of the Alliance for Aging Research, which has recently launched a website and a series of webcasts (no charge) for anyone interested in science, aging and the public interest. Future debates and webcasts will be devoted to questions such as: -What is the social model to ensure generational equity in America? -Does longevity science make good economic sense? -Should age count in allocating healthcare resources? For more information and details on how to receive webcasts in the future, visit the Sage Crossroads site at: http://www.sagecrossroads.net/contact.cfm ----------------------<<< >>>------------------------ INNER LIFE OF HEALERS Readers of this newsletter will be interested in "The Inner Life of Healers Program" sponsored by the University of Minnesota's Center for Spirituality and Healing. For more information, see: http://www.csh.umn.edu/Programs/InnerLife/index.html For the Center's Newsletter, visit: http://www.csh.umn.edu/about/newsletter/fall02.pdf ----------------------<<< >>>------------------------ FROM RULES TO CARING PRACTICES "From Rules To Caring Practices: Ethics And Community-Based Care For Elders" (Produced by The Park Ridge Center). This video presents four brief scenarios that will trigger thought and discussion around the human and emotional issues that are an integral part of home caregiving. Each scenario sheds light on a different aspect of home caregiving. Highly recommended (HRM). Winner of the 2001 Silver Hugo Award for Best Video in the Adult Education Category. Available from Terra Nova Films at http://www.terranova.org/ ----------------------<<< >>>------------------------ END-OF-LIFE CARE CERTIFICATE PROGRAM The Smith School for Social Work has announced its 2003 End-of-Life Care Certificate Program for advanced practice social workers. This is the fourth year of the school's Program for post-Masters social work practitioners. The intensive, clinically-focused curriculum consists of two six-day summer sessions, in residence at Chapin House on the Smith College campus in Northampton, MA, punctuated by an eight-month internship in the participant's work setting. Course content includes psychodynamic theory, ethics, spirituality, hospice and palliative care and much more. New to the program this year is a unit on working with issues of sexual orientation in end-of-life care. Current deadline for applications is March 15, 2003. To learn more about this program, contact Donna DeLuca by phone at (413) 585-3722 Full program materials and an application form are available on the web at: http://www.smith.edu/ssw/endofcert.htm ----------------------<<< >>>------------------------ COMING EVENTS CARE OF DYING. Supportive Care of the Dying: A Coalition for Compassionate Care (SCD: CCC) is sponsoring three "Toolkit for Nurturing Excellence at End-of-Life Transition" (TNEEL) workshops in 2003: Baltimore (Feb. 25, 2003; Philadelphia (Mar. 4, 2003); and Spokane, WA, later in 2003. Workshops introduce an interactive computer program preparing nurses and other educators to teach evidence-based, end-of-life care. For a copy of the electronic TNEEL workshop brochure, contact Carol Lieberman at clieberman@providence.org with the subject line stating, "TNEEL", or visit http://www.careofdying.org ETHICS COMMITTEES. Minnesota Network of Healthcare Ethics Committees Conference (St. Paul, MN, February 27, 2003) A group of ethics committees throughout the state and based at the University of Minnesota's Center for Bioethics, is hosting a conference "Responding to Controversies: Using Organizational Ethics in Healthcare." The conference will present models for ethical decision-making in order to provide a framework for building compliance with JCAHO's organizational ethics requirements. The purpose of the conference is to instruct local ethics committee members, administrators, and managers of health care organizations about organizational ethics principles and theories. CMEs available. For additional information visit http://www.bioethics.umn.edu/ and click on MNHEC. PALLIATIVE CARE. (Philadelphia, PA, Feb. 27 - Mar. 2, 2003). The Center to Advance Palliative Care (CAPC) presents "Planning, Funding, and Sustaining a Hospital-based Palliative Care Program: Tools and Strategies for Success." Comprehensive seminar is for healthcare managers and professionals. Contact Barbara Mastrodi at (212) 201-2680 for more information. For more about this event and about CAPC, visit: http://www.capcmssm.org/ FAITH & ALZHEIMER'S. "You Are One of Us: How faith Communities Can Sustain Ties with Alzheimer Patients and Their Families." (Bangor, ME, Mar. 1, 2003) A day-long seminar co-sponsored by The Maine Alzheimer's Association and Bangor Theological Seminary on Saturday, 9:30 a.m.-3:00 p.m. (Snow date: March 8). Registration fee is $35.00 which includes materials and lunch. To for more information, or to register call Sue Davenport at Bangor Theological Seminary, 1-800-287-6781 Ext. 124 RELIGION AND HEALTH. "David B. Larson Memorial Lecture on Religion and Health." (Durham, NC, Mar. 5, 2003). Speaker: Jeffrey C. Levin. For information, contact Harold Koenig: koenig@geri.duke.edu SPIRITUALITY AND MEDICINE. (Melbourne, FL, Mar. 10-11, 2003). Speaker: Harold G. Koenig. For information, contact Robert M. Bruckart at rbruckar@health-first.org SPIRITUAL TRADITIONS & CAREGIVING. 2003 Wingspread Conference Workshop: "Retrieving the Spiritual Traditions for Caregiving and Caregivers" (Chicago, IL, March 12, 2003). Five central themes to capture core values and teachings related to aging and the elderly in their spiritual journey. For additional information, contact Rita Chow at 202-479-6655 BODY, SOUL AND BIOETHICS. Gilbert Meilaender, a member of the President's Bioethics Council, will present a public lecture (no charge) at Assumption College, 500 Salisbury Street, Worcester, MA on March 13, 2003, 7:00 PM-8:30 PM. For details, contact: acpa@assumption.edu END OF LIFE ISSUES. (Boston College, Mar. 17-18, 2003). Conference speakers, with support from NIA, include ethicists and gerontologists addressing topics such as: . End of life care: Does age matter? · Legal aspects of end of life decisions · Educating the next generation of professionals for healing and facilitating a peaceful end · Training clinicians for interprofessional collaboration · Accommodating needs of patients and family · Roles of religiosity and spirituality Attendance is limited. For more information and a brochure, contact Carla Boudreau at boudreca@bc.edu or (617) 552-1479 SPIRITUALITY & MENTAL HEALTH Conference (Universal City, CA, March 20, 2003). Hilton Universal City. Sponsored by Pacific Clinics. For additional information, contact Nancy Hochstein at (626) 254-5024 ----------------------<<< >>>------------------------ ETHICAL DILEMMAS WORKSHOP For a workshop on "Ethical Dilemmas in Work with Older People" visit: http://www.hrmoody.com/sw.html#6 SPEAKERS ON BIOETHICS For speakers on bioethics and aging, see NextAge Speakers Bureau at: http://www.nextagespeakers.com/speakerlist.asp?topic=Bioethics xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx This electronic newsletter, edited by Harry (Rick) Moody, is published by the Institute for Human Values in Aging with the support from the Robert Wood Johnson Foundation. To submit items of interest or request subscription changes, contact hrmoody@yahoo.com For additional information, visit http://www.hrmoody.com (c) Copyright 2003; all rights reserved.