Ethics Grand Rounds

  • Conversations about Challenging End-of-Life Cases: Ethics Debriefing in the Medical Surgical Intensive Care Unit

    Clinicians frequently encounter and grapple with complex ethical issues and perplexing moral dilemmas in critical care settings. Intensive care unit (ICU) clinicians often experience moral distress in situations in which the ethically right course of action is intuitively known, but cannot be acted on. Most challenging cases pertain to end-of-life issues. Researchers have shown that moral distress and moral residue are common among critical care nurses. It is, therefore, essential that all ICU clinicians (and nurses, in particular) have an ongoing opportunity to work safely through these ethical dilemmas and conflicts. In this article, we describe the medical surgical intensive care unit (MSICU) experience with its monthly ethics initiative and explore the next steps to enhance its use through maximizing attendance and value to MSICU clinicians.

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  • Making Ethical Choices: An Ethical Decision-Making Handbook for Health Care Practitioners & Administrators Second Edition

    About the book:

    Health care practice and administration is fraught with complex moral issues and dilemmas. Shifting paradigms in the health care system, such as limited resources, increased emphasis on patients’ rights, and moral diversity, have profound and far-reaching ramifications that impact us all – health care recipients and their families, health care professionals and administrators, and other stakeholders.

    On the one hand, advances in medical technology have created renewed hope and exciting horizons in our quest for cures and treatments of illnesses that cause pain, suffering and, frequently, premature death. On the other hand, the development of new investigative and treatment techniques have added complex and baffling ethical questions to old moral quandaries in health care.

    Generally, health care professionals and administrators conscientiously follow personal or interdisciplinary frameworks for making decisions. These processes are enmeshed with a wealth of professional and personal experiences. Yet, how often is the health care professional or administrator baffled by difficult and perplexing circumstances that possess a value foundation. Commonly asked questions include: Which of these difficult alternatives should I choose? What course of action is most appropriate in this situation, and who should so decide? Answers to questions such as these often have very far-reaching ramifications, and they may on some occasions determine whether a patient is treated fairly or, indeed, whether he lives or dies.

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  • What Makes Research Unethical?

    Giles Scofield prepares a presentation that addresses “What Makes Research Unethical?”

    View the PowerPoint slides:…pdf

  • The Ethical Challenges of Medicine Today

    “The Ethical Challenges of Medicine Today: Drawing on the Wisdom of Vatican II”

    Christine Jamieson participates in part five in a six-part series: A Church for the 21st Century: The Spirit of Vatican II in Our Time.

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  • Stem Cell Considerations and Its Implications

    On May 9, 2002, Canada’s Minister of Health introduced in the House of Commons the Act Respecting Assisted Human Reproduction. The Act is seen by many, including the Health Minister as “middle-of-the-road” legislation because, on the one hand, it prohibits the creation of embryo clones not only for reproduction but also for the purpose of research (the latter is permitted in Great Britain) while, on the other hand, allowing research on “left-over” embryos after in-vitro fertilization (which is not allowed in the United States).

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