Ethics Grand Rounds

Affirming an Ethic of Care:
The Social Nature of Healthcare
October 4, 2013

Fall Conference 2013 Brochure

Program

8:00 a.m.	Registration and Refreshments
8:45 a.m.	Morning Prayer with Catholic Health Association of Ontario
9:00 a.m.	Welcoming Remarks
9:10 a.m.	Opening Address Dr. David R. Kuhl What We Know, Cures; Who We Are, Heals
10:10 a.m.	Question and Answer Period
10:30 a.m.	Refreshment Break
10:45 a.m.	Presentation Josie Walsh The Social Nature of Managing Patient Flow
11:45 a.m.	Question and Answer Period
12:00 p.m.	Lunch with Musical Interlude
1:00 p.m.	Presentation Kirby Kranabetter Six Months Behind Bedrails: A Patient’s Perspective on Good Care
2:00 p.m.	Question and Answer Period
2:15 p.m.	Refreshment Break
2:30 p.m.	Closing Address Dr. Barry Hoffmaster The Social Nature of Bioethics
3:30 p.m.	Question and Answer Period
3:50 p.m.	Closing Comments

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Presenters

David R. Kuhl, MD, MHSc, PhD
Director, Centre for Practitioner Renewal, Providence Health Care, Professor, Department of Family Practice, Faculty of Medicine, University of British Columbia
What We Know, Cures; Who We Are, Heals
The challenges faced by healthcare providers are varied: economic restraint and restructuring, rapidly developing technologies, increased patient complexity and an aging population, to name a few. Healthcare is generally based on a business model of efficiency. The work we do is based on relationships. How are healthcare providers sustained in the work place? What is the effect of being in the presence of suffering? What might be regarded as healing, repairing or restoring resilience in the healthcare workplace? How do we know and understand ourselves, our relationship to others (patients, families and colleagues) and our relationship with the work we do? This presentation will focus on the complexity of relationships in the healthcare work place.

Josie Walsh, RN, MHSc, CHE
President and CEO, Providence Healthcare, Toronto
The Social Nature of Managing Patient Flow
In 2009, to help meet the increasingly challenging needs of the healthcare system, significant change was needed. Patients were experiencing too many inefficient transitions and hand-offs as they moved from acute care through to rehabilitation and finally home. Patient flow and patient outcomes suffered across the system. Providence’s solution involved transformation of each of the hospital units. This was an innovative, new approach to help more people access the right care in the right place at the right time. Three key principles guided our approach: Partnerships and relationship-building with health service providers and funders; meaningful engagement with patients and their families and frontline clinicians; and the patient care experience – hearing the voice of the patient, with a focus on quality and safety. Success would be achieved by capitalizing on the value of the social nature of healthcare and in the creation of tight personal connections with people at each stage of the patient journey.

Kirby Kranabetter, MA
Director of Mission, Ethics and Client Relations, Bruyère Continuing Care, Ottawa
Six Months Behind Bedrails: A Patient’s Perspective on Good Care
What constitutes good care? How much are hope and despair woven within the care we receive? In this presentation I share my perspective on life in a healthcare institution following my diving accident which left me a quadriplegic. What worked well and not so well, and what are the implications for healthcare practitioners.

Barry Hoffmaster, PhD
Professor, Department of Philosophy, University of Western Ontario, London
The Social Nature of Bioethics
Moral philosophy is an abstract theoretical exercise. Bioethics is a practical social endeavor. To be legitimate and successful, a social morality such as bioethics must be rational. This presentation outlines a process-based, socially oriented theory of reason for individual decision making, institutional design, and policy making and uses real examples to illustrate the operation of this rationality in how children discover, despite a conspiracy of silence, that they have cancer and are dying and how moral compromise is used in the design of a policy for allocating kidneys from deceased donors for transplantation.

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Registration Information

Registration Fee:
(Includes Lunch and Refreshment Breaks)
Regular Rate: $150.00
Reduced Rate: $75.00
Seniors, Full-Time Students, CHAO Conference Registrants, & CCE Affiliates
(Centre for Clinical Ethics Affiliates include: Providence Healthcare, St. Joseph’s Health Centre, St. Michael’s Hospital, Pembroke Regional Hospital, Rouge Valley Health System, Runnymede Healthcare Centre, St. Joseph’s Health System Hamilton, Toronto Grace Health Centre, Waypoint Centre for Mental Health Care and West Park Healthcare Centre)

Payment:
Please make cheque(s) payable to:
Centre for Clinical Ethics

For more information please contact:
Lynda Sullivan, Centre for Clinical Ethics
Telephone: (416) 530-6750
Fax: (416) 530-6621
E-mail: lsullivan@stjoestoronto.ca

For hotel reservations please call:
Toronto Marriott Bloor Yorkville
90 Bloor Street East (at Yonge)
(416) 961-8000

Affirming an Ethic of Care:
What Patients Teach Us
October 3, 2014

Fall Conference 2014 Brochure

Program

8:00 a.m.	Registration and Refreshments
8:45 a.m.	Morning Prayer with Catholic Health Association of Ontario
9:00 a.m.	Welcoming Remarks
9:10 a.m.	Opening Address Dr. Larry R. Churchill The Everyday Ethics of Healthcare: Lessons from Patients
10:10 a.m.	Question and Answer Period
10:30 a.m.	Refreshment Break
10:45 a.m.	Presentation Elizabeth Buller “Can you hear me?” The Importance of Listening in Improving the Patient Experience
11:45 a.m.	Question and Answer Period
12:00 p.m.	Lunch with Musical Interlude
1:00 p.m.	Presentation Introduction: Lorraine Pinto Presenters: Mary Ellen Chater and Laura Berry End of Life Care: Through the Eyes of the Family
2:00 p.m.	Question and Answer Period
2:15 p.m.	Refreshment Break
2:30 p.m.	Closing Address Dr. Mark Miller Bioethics as Caring: Twenty Years’ Experience of Listening & Learning as a Bioethicist
3:30 p.m.	Question and Answer Period
3:50 p.m.	Closing Comments

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Presenters

Larry R. Churchill, PhD
Ann Geddes Stahlman Professor of Medical Ethics, Vanderbilt University, Nashville, TN
The Everyday Ethics of Healthcare: Lessons from Patients
The moral quality of the relationship between clinicians and patients is foundational in creating a therapeutic alliance, and the actions and attitudes that lead to healing. Drawing on interviews with patients and clinicians, this talk will explore the elements needed to promote therapeutic alliance. The focus will be on everyday virtues that inform practice rather than the principles that guide big decisions. We will consider how patient values might inform professional codes and concrete suggestions for revisions will be offered.

Elizabeth Buller, BScN, MA, MHA
President and CEO, St. Joseph’s Health Centre, Toronto
“Can you hear me?” The Importance of Listening in Improving the Patient Experience
Today’s health care providers often feel rushed to meet the competing demands of their shift and the needs of multiple patients. In this rush health care providers often struggle to find time to actively listen and learn from patients. A lot of patients, especially in hospital, are out of their comfort zones, vulnerable, and unnerved by the health provider that is dealing with them. Knowing that you are being listened to is incredibly important and health professionals answering and addressing questions in a way that highlights this can only improve the experience for the user. The evidence demonstrates that listening to our patients and families improves overall quality of care. In our fast paced health care environment how do we create a culture of listening? This talk will explore the evidence for listening and share some ideas about how to shift organizational culture.

Introduction: Lorraine Pinto, BSW, MSW, RSW
Presenters: Mary Ellen Chater and Laura Berry
End of Life Care: Through the Eyes of the Family
There is no denying or hiding… death, dying or end of life is a journey that we will all face at some point. The quality of the end of life experience matters – particularly to patients and their families. How well are health care organizations faring in the delivery of quality end of life care? This question cannot simply be answered by reviewing hospital statistics alone as they capture quantitative, not qualitative, outcomes. To evaluate the qualitative experience and drive change, we need to listen to the feedback provided by families.

Within the context of end of life care, Mary Ellen Chater & Laura Berry will each share their story and the personal journey they walked with their loved one as a spouse and parent respectively. They will provide us with insights into the highs and lows of their experience. What did the health care team do best? Are there improvements that could be made? Has there been an impact on their grieving and memories they hold on to? They will also recommend strategies to ensure an effective collaboration between families and the health care team on this shared journey.

Mark Miller, PhD, MDiv
Clinical Ethicist, Centre for Clinical Ethics
Bioethics as Caring: Twenty Years’ Experience of Listening & Learning as a Bioethicist
The point of bioethics in the clinical setting is not just to find the ‘right’ answer. Indeed, what happens if a right answer is reached, but everybody is unhappy? This talk will explore 20 years of learning to listen – to patients, their families, doctors and caregivers. It will seek to bring some light into the roles of communicating, clarifying ethical thinking and pathways of decision making, and acknowledging both moral distress and moral residue.

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Registration Information

Registration Fee:
(Includes Lunch and Refreshment Breaks)
Regular Rate: $150.00
Reduced Rate: $75.00
Seniors, Full-Time Students, CHAO Conference Registrants, & CCE Affiliates
(Centre for Clinical Ethics Affiliates include: Providence Healthcare, St. Joseph’s Health Centre, St. Michael’s Hospital, Pembroke Regional Hospital, Rouge Valley Health System, Runnymede Healthcare Centre, St. Joseph’s Health System Hamilton, Toronto Grace Health Centre, Waypoint Centre for Mental Health Care and West Park Healthcare Centre)

Payment:
Please make cheque(s) payable to:
Centre for Clinical Ethics

For more information please contact:
Lynda Sullivan, Centre for Clinical Ethics
Telephone: (416) 530-6750
Fax: (416) 530-6621
E-mail: lsullivan@stjoestoronto.ca

For hotel reservations please call:
Toronto Marriott Bloor Yorkville
90 Bloor Street East (at Yonge)
(416) 961-8000

Affirming an Ethic of Care:
Bridging the Gaps at the End of Life
October 2, 2015

Fall Conference 2015 Brochure

Program

8:00 a.m.	Registration and Refreshments
8:45 a.m.	Morning Prayer with Catholic Health Association of Ontario
9:00 a.m.	Welcoming Remarks
9:10 a.m.	Opening Address Balfour M. Mount The Potential for Healing at the End of Life
10:10 a.m.	Question and Answer Period
10:30 a.m.	Refreshment Break
10:45 a.m.	Presentation Naheed Dosani Living & Dying on the Streets: Palliative Education And Care for the Homeless (PEACH)David Byrne Dying Inside: The End of Life Experience for Inmates and Health Care Providers in Federal Correctional Institutions Dan Haley Alternatives to Incarceration: Dying with Dignity in the Community
11:45 a.m.	Question and Answer Period
12:00 p.m.	Lunch with Musical Interlude
1:00 p.m.	Presentation Katherine Rouleau End of Life Care at the End of our Road: Spirits, symptoms and surprises
2:00 p.m.	Question and Answer Period
2:15 p.m.	Refreshment Break
2:30 p.m.	Closing Address Debra Parker Oliver Validation and Support for the Family Caregiver: The Overlooked Patient
3:30 p.m.	Question and Answer Period
3:50 p.m.	Closing Comments

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Presenters

Balfour M. Mount, OC, OQ, MD, FRCSC, LLD
Emeritus Professor of Medicine at McGill University
The Potential for Healing at the End of Life
The biomedical model focuses on the pathophysiology of disease while neglecting the broader existential depths that frame our experience of illness. Our potential for healing in the face of progressive disease, a potential rooted in the special relationship formed between healer and sufferer, so familiar to Osler, the shamans of primitive cultures and faith healers, remains an untapped resource. Cassell has eloquently expressed the reality underlying the flaw in modern medicine’s paradigm, “same disease, different patient – different illness, pain and suffering.”

Naheed Dosani, MD, CCFP, BSc
Palliative Care and Family Physician, Inner City Health Associates, Palliative Education And Care for the Homeless (PEACH), St. Michael’s Hospital
Living & Dying on the Streets: Palliative Education And Care for the Homeless (PEACH)
This talk will describe the unique issues and challenges faced by homeless and vulnerably housed patients with life-limiting illness and learn about concerns relating to communication and care co-ordination for this vulnerable population. It will also address strategies to support quality-of-life interventions (medical and psychological) and safe discharge from the hospital, as well as introduce a new model of care: PEACH (Palliative Education and Care for the Homeless).

David Byrne, BA, MDiv, PhD (Cand.)
Director, Programs, Peterborough Community Chaplaincy
Dying Inside: The End of Life Experience for Inmates and Health Care Providers in Federal Correctional Institutions
In 2014 the Office of the Correctional Investigator completed a study of the Correctional Service of Canada’s (CSC) mortality review process that produced ‘disturbing results.’ The most alarming of which were that the average age of inmates at death is just 60 years and that standards for health care for dying inmates are critically substandard. Despite these results, and that inmates near end of life pose little threat to the community, they are rarely released from prison to receive palliative care. This brief presentation will outline the current conditions facing dying offenders and will discuss how reports of moral distress by CSC health care professionals help to illuminate the various ethical issues that have yet to be resolved.

Dan Haley
Executive Director, Peterborough Community Chaplaincy
Dying Inside: The End of Life Experience for Inmates and Health Care Providers in Federal Correctional Institutions
Impacted by time spent with dying inmates in federal correctional institutions, shortly after Community Chaplain Dan Haley opened his transition house in Peterborough, Ontario in 2007 he began to accept offenders as part of an emerging palliative care program. Eight years later the program has received widespread recognition as a model for dignity enabling end of life care for offenders, especially those most difficult to serve. In this brief presentation Dan will outline the process towards and motivation for the creation of his program, describing the moral obligation that communities have to care for offenders near death.

Katherine Rouleau, MDCM, CCFP, MHSc
Associate Professor, Department of Family and Community Medicine, University of Toronto
End of Life Care at the End of our Road: Spirits, symptoms and surprises
This presentation will begin with an overview of some key information from the WHO Palliative Care Atlas which outlines the state of end of life care around the world. The concepts of life and death in various parts of the world will be explored in order to illustrate the great diversity that exists. Some of the hurdles we face as a global community in meeting the end of life care needs for the world’s population will be discussed and some potential “steps and strategies” proposed.

Debra Parker Oliver, MSW, PhD
Professor, School of Medicine, Department of Family and Community Medicine, University of Missouri
Validation and Support for the Family Caregiver: The Overlooked Patient
After more than 30 years as a Hospice social worker, administrator and researcher, Dr Parker Oliver found herself a caregiver of a hospice patient and unprepared for the end of life journey, when her husband was diagnosed with Stage IV cancer. She shares her personal experience with the message that there are two patients in this journey. One is dying, the other feels as though they are dying, but will survive to find themselves alone. For the dying patient there is a care plan, medications, equipment, professional help, family help, and social support. For the caregiver the needs often go unidentified and unaddressed. Caregivers remain quiet about their own needs, focusing on their loved one, giving all they have to keep promises and bring their loved ones peace. Caregiving is the journey of a million losses, and there is no team member assigned to focus on the caregiver. Dr. Parker Oliver advocates that the caregivers need a care team and a care plan as well, and the journey continues beyond the death of their loved one.

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Registration Information

Registration Fee:
(Includes Lunch and Refreshment Breaks)
Regular Rate: $150.00
Reduced Rate: $75.00
Seniors, Full-Time Students, CHAO Conference Registrants, & CCE Affiliates
(Centre for Clinical Ethics Affiliates include: Providence Healthcare, St. Joseph’s Health Centre, St. Michael’s Hospital, Pembroke Regional Hospital, Rouge Valley Health System, Runnymede Healthcare Centre, St. Joseph’s Health System Hamilton, Toronto Grace Health Centre, Waypoint Centre for Mental Health Care and West Park Healthcare Centre)

Payment:
Please make cheque(s) payable to:
Centre for Clinical Ethics

For more information please contact:
Lynda Sullivan, Centre for Clinical Ethics
Telephone: (416) 530-6750
Fax: (416) 530-6621
E-mail: lsullivan@stjoestoronto.ca

For hotel reservations please call:
Toronto Marriott Bloor Yorkville
90 Bloor Street East (at Yonge)
(416) 961-8000

Affirming an Ethic of Care:
Meeting the Needs of Vulnerable Persons
October 12, 2012

Fall Conference 2012 Brochure

Program

8:00 a.m.	Registration and Refreshments
8:45 a.m.	Morning Prayer with Catholic Health Association of Ontario
9:00 a.m.	Welcoming Remarks
9:10 a.m.	Opening Address Dr. Daniel P. Sulmasy Dignity, Vulnerability, and the Care of the Patient
10:10 a.m.	Question and Answer Period
10:30 a.m.	Refreshment Break
10:45 a.m.	Presentation Len M. Wood Nothing About Us, Without Us – Recovery
11:45 a.m.	Question and Answer Period
12:00 p.m.	Lunch with Musical Interlude
1:00 p.m.	Presentation Dr. Vicky Stergiopoulos From Bedside to Policy: Addressing Challenges in Inner City Health
2:00 p.m.	Question and Answer Period
2:15 p.m.	Refreshment Break
2:30 p.m.	Closing Address Prof. Margaret Somerville Human like me? Vulnerable Persons as “Non-Persons”
3:30 p.m.	Question and Answer Period
3:50 p.m.	Closing Comments

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Presenters

Daniel P. Sulmasy, MD, PhD, FACP
Kilbride-Clinton Professor of Medicine and Ethics in the Department of Medicine and Divinity School and Associate Director, the MacLean Center for Clinical Medical Ethics, the University of Chicago
Dignity, Vulnerability, and the Care of the Patient
The talk will explore the notions of dignity and vulnerability and the relationship between these two concepts, connecting them to a spirituality and ethic of Christian health care. The vulnerability of the health care professional will also be addressed.

Len M. Wood
Consumer/Survivor (Mental Health & Addictions), President of MDAO (Mood Disorders Association of Ontario)
Nothing About Us, Without Us – Recovery
This presentation will explain the recovery concept, the need for inclusiveness, the need to develop listening skills and the difference between helping and serving.

Vicky Stergiopoulos, MSc, MD, MHSc, FRCPC
Clinician Scientist and Psychiatrist-In-Chief at St. Michael’s Hospital, Toronto
From Bedside to Policy: Addressing Challenges in Inner City Health
What are the challenges to care at the individual, program and system levels for socially and economically disadvantaged populations?

What have we learned from research, clinical experience, and the voices of people with lived experience and their families? How can we redesign our system of care for some of the most vulnerable people in our community? How can we most effectively advocate at the individual and system levels? These are some of the questions that Dr. Stergiopoulos will address, drawing from her clinical, research and administrative roles and national and provincial health policy frameworks.

Margaret Somerville, AM, FRSC, DCL
Professorships in the Faculty of Law (Samuel Gale Chair) and the Faculty of Medicine, McGill University, Montreal and Founding Director of the McGill Centre for Medicine, Ethics and Law
Human like me? Vulnerable Persons as “Non-Persons”
Is the marginalization and killing of others possible, palpable, and justifiable because these others are no longer considered human? Does the human tendency to “dis-identify” from and “depersonalize” others provide us with justification for abdicating responsibility in face of the other? Is legalizing physician assisted suicide another expression of this dis-identification?

These questions will provide the backdrop to Prof. Somerville’s presentation. Drawing on the report entitled “Dying with Dignity”, a document tabled by an all-party select committee on Tuesday, March 20, 2012 in Quebec, Prof. Somerville will unpack the meaning of the document in relation to meeting the needs of vulnerable persons.

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Registration Information

Registration Fee:
(Includes Lunch and Refreshment Breaks)
Regular Rate: $150.00
Reduced Rate: $75.00
Seniors, Full-Time Students, CHAO Conference Registrants, & CCE Affiliates
(Centre for Clinical Ethics Affiliates include: Providence Healthcare, St. Joseph’s Health Centre, St. Michael’s Hospital, Pembroke Regional Hospital, Rouge Valley Health System, Runnymede Healthcare Centre, St. Joseph’s Health Centre Sudbury, St. Joseph’s Health System Hamilton, Waypoint Centre for Mental Health Care, and West Park Healthcare Centre)

Payment:
Please make cheque(s) payable to:
Centre for Clinical Ethics

For more information please contact:
Lynda Sullivan, Centre for Clinical Ethics
Telephone: (416) 530-6750
Fax: (416) 530-6621
E-mail: lsullivan@stjoestoronto.ca

For hotel reservations please call:
Courtyard by Marriott Downtown Toronto
475 Yonge Street Toronto, Ontario
(416) 924-0611