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Conference by Unity Health’s Centre for Clinical Ethics – 2021 – explores caring for Canada’s seniors
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Ethics Grand Rounds, December 6, 2021
Ethics Grand Rounds
A refusal of a life-saving hysterectomy due to a delusion of pregnancy
Monday, December 6, 2021 | 12-1pm | Virtual
Presenters: Julie Maggi, MD, FRCPC, staff psychiatrist Unity Health in Toronto; Marnina Norys, PhD, Ethicist, Humber River Hospital; Eliane Shore, MD, MSc, FRCSC, Staff Physician, Division of Gynaecologic Surgery and Pelvic Medicine, Unity Health Toronto; Michael Szego, PhD, MHSc, Senior Director, Centre for Clinical Ethics, Unity Health Toronto
This ethics grand rounds will feature a case discussion involving a postmenopausal woman in her 50s who was diagnosed with Grade 1 endometrioid Adenocarcinoma. A unique feature of this case was that she declined a proposed hysterectomy due to long held delusion of pregnancy associated with schizophrenia. Capable patients have the right to refuse proposed treatments. In this case, the patient was reasonably well functioning considering the nature of her psychiatric illness, although there was a consensus that the patient’s delusions distorted her ability to appreciate the risks of accepting or refusing surgery. In this presentation, we will discuss the potential harms and benefits of surgery and the careful stepwise approach we adopted in an attempt to support the patient’s decisional capacity as a necessary step prior to attempting any surgical procedures. We will also discuss the positive impact of interdisciplinary collaboration with various healthcare providers including those, such as her family physician, who have maintained a long standing relationship with the patient.
Goals and Objectives
1) To identify the 2-part test for capacity and how it applies in this case
2) To learn about the Mental Health Act and how it can be used when patients are at risk of harming themselves
3) To discuss the ethics of potentially forcing a procedure on an unwilling but incapable patient
CME Accreditation — Physician attendees will be eligible to receive one Section 1 Continuing Professional Development (CPD) credit as certified by the Royal College of Physicians and Surgeons of Canada. Links for providing feedback and registering for CME credit will be available live in the session.
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Fall Conference 2020
The annual CCE Ethics Conference is changing formats. This year we will hold a series of lectures/panel discussion over three consecutive Thursdays in November. Our goal is to provide an opportunity to reflect on the ethical issues raised during the pandemic in a format that is mindful of both Zoom fatigue and the constraints on everyone’s time. The series is free and more information about the conference theme, speakers, and the webinar links are listed below. We hope to see you at one or all of the seminars in the series!
Our theme this year is Confronting injustice: exploring ethical issues raised during COVID-19.
The Canadian experience of the COVID-19 pandemic has been difficult for everyone. The pandemic has made gaps in our social and health care systems deeper and more visible. People who are elderly, racialized, disabled, under-housed, low income, or otherwise marginalized have been — and continue to be — disproportionately exposed to COVID-19 and affected by public health measures.
This series seeks to answer questions such as:
- What are the lessons we have learned about gaps in social supports or about justice in decision-making during a pandemic?
- How can these learnings help us reduce the impact of the pandemic on staff, patients/residents/clients, and families in the future?
- How can we ensure pandemic response and social systems are more equitable going forward (in this wave, future recovery or further waves)?
Series Dates:
Thursday November 19th (12-1:30pm): Impacts of the COVID-19 pandemic on racialized communities
Panelists:
- Roberta Timothy PhD, Assistant Professor, Dalla Lana School of Public Health, University of Toronto
- Liben Gebremikael MA, Executive Director, TAIBU Community Health Centre
- Melissa Stevenson RN, BScN, Waashkeshuyaan Unit Coordinator, Anishnawbe Health Toronto
Thursday November 26th (12-1:30pm): Impacts of the COVID-19 pandemic on people who use substances
Panelists:
- Edna Simmons, Trauma Counsellor Advocate
- Dan Werb PhD, Research Scientist at the Li Ka Shing Knowledge Institute, St. Michael’s Hospital
Thursday December 3rd (12-1:00pm): Ethical issues in the COVID-19 pandemic: local and global perspectives. Are lessons ever learned?
Ross Upshur MD, Professor and Head, Division of Clinical Public Health at the Dalla Lana School of Public Health and the Assistant Director of the Lunenfeld Tanenbaum Research Institute, Sinai Health System.
If you have any questions please contact: Lynda Sullivan, Centre for Clinical Ethics Telephone: (416) 530-6750 E-mail: Lynda.Sullivan@unityhealth.to
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Fall Conference 2019
Centre for Clinical Ethics Fall Conference 2019
Friday, November 22, 2019
Understanding and Responding to Bias in Healthcare
Patients deserve the same high quality of care regardless of their age, race, language, religion, gender, sexual orientation, or other personal characteristics. However, data suggests that healthcare providers exhibit the same degree of bias as the general population. Even when receiving care from providers who are well-meaning and aware of how negative stereotypes affect patients, biases can unconsciously influence patients’ care, including the diagnoses and treatment recommendations they receive, the number of questions they are asked, and the number of tests ordered. Biases can also shape how providers interact with patients through their body language, eye contact, and physical proximity while having a conversation. In other words, characteristics that are not relevant to treating a patient can have a profound effect on their experience in the healthcare system. Similarly, bias can occur laterally between healthcare providers or between employers and healthcare providers, negatively impacting the work environment. The goal of the 26th annual Centre for Clinical Ethics conference is to have a conversation about the role of bias in healthcare and what can be done about it.
Presenters
- Dr. Pat Croskerry, MD, PhD, FRCP(Edin), Professor, Department of Emergency Medicine, Director, Critical Thinking Program, Dalhousie University Medical School, Halifax, Nova Scotia
- Latisha Cunningham, MSHROD, PHR, SHRM-CP, President and Principal Consultant, Leadership and Diversity Consulting
- Leonard Benoit, Indigenous Patient Navigatoion Specialist, Family Medicine, St. Michael’s Hospital
- Serena Thompson, Patient viewpoint
- Dr. Onye Nnorom, MDCM, CCFP, MPH, FRCPC, Black Health Theme Lead, MD Program, Faculty of Medicine, University of Toronto, Associate Program Director, Public Health and Preventive Medicine Residency Program, Dalla Lana School of Public Health, University of Toronto
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Providing Care to help the homeless in Toronto
