The New York City Health and Hospitals Corporation is the largest municipal health care system in the United States. This year, its John Corser Ethics Conference is tackling one of the biggest, yet perennially neglected, topics in clinical bioethics: medical decision making for patients without surrogates.
The term "unbefriended" describes those persons--regardless of age--who reach the end of life with neither decision-making capacity nor surrogates. All concerned agree these patients need special compassion and protection. Yet it can be unclear at the end of life which treatments are in the patients' best interest and which are an undesirable burden.
Compelling case presentations and audience interaction will define and clarify clinical, ethical, and legal approaches to the New York Family Health Care Decision Act.
At the conclusion of the seminar, attendees will be able to:
- Identify the scope of the national response to the Unbefriended client
- Describe at least 2 issues which are relevant to the national discussion of the Unbefriended client.
- Identify issues considered when drafting the FHCDA and how they determined the outcome pertaining to the unbefriended.
- Identify clinical and ethical issues confronted when working with the Unbefriended client.
- Describe clinical and ethical impasses created by the FHCDA law pertaining to the Unbefriended cllient.
- Identify potential solutions to ethical/legal issues that confront clinicians when working with their Unbefriended clients.
This program is free to all NYC HHC employees. A light breakfast and lunch will be served. Continuing Education Credits have been applied for. Space is limited.
8:00-8:30
Breakfast and Registration
8:30-8:45
Welcome and Opening Remarks
Ross Wilson, MD HHC Senior Vice President, Quality and Corporate Chief Medical Office
8:45-9:00
Nature of Conference and Opening Remarks
Susan Sanelli-Russo, MD, Chairperson of the HHC Ethics Council, Director of Neurology Queens Hospital Center.
9:00
Conference Algorithm
Nancy L. Dubler, LLB, Ethics Consultant, New York City Health and Hospitals Association
9:15
Lecture: Raising Legal Consciousness about Unbefriended Persons
Erica Wood, JD, Assistant Director, American Bar Association Commission on Law and Aging
9:30-10:30
Presentation and Interactive Discussion of Case: PEG Placement for Nursing Home Resident
Audience Response Vote 1
Panel Discussion: Experts from the facility and invited faculty
Audience Response Vote 2
Audience discussion
10:45
Presentation and Interactive Discussion of Case: DNR Order for a Hospital Patient Admitted from Nursing Home
Audience Response Vote 1
Panel Discussion: Experts from the facility and invited faculty
Audience Response Vote 2
Audience discussion
11:45
Lecture: The Evolution of NYS Laws on Health Care Decisions for Unbefriended Patients
Robert Swidler, JD, Vice President Legal Services, St. Peter’s Health Partners, Governor’s appointee to the NYS Task Force on Life and the Law 7chevy
12:00
Lecture: Ethical Complexity of Protecting Unbefriended Patients under the FHCDA
Tia P. Powelll, MD, Director, Montefiore Einstein Center
for Bioethics; Director, Einstein Cardozo Master of Science in Bioethics; Professor of Clinical Epidemiology,
Division of Bioethics & of Clinical Psychiatry, AECOM
12:15
Lecture: National Efforts to Protect Unbefriended Patients
Erica Wood, JD
12:30
Working Lunch Video: “Food for Thought” Modeling Mediation Pertinent to the Unbefriended
1:15
Presentation and Interactive Discussion of Case: Refusal of Treatment by Hospital Patient with a Psychiatric Diagnosis
Audience Response Vote 1
Panel Discussion: Experts from the facility and invited faculty
Audience Response Vote 2
Audience discussion
2:15
Panel Discussion of Day’s Activities/Audience Discussion
Erica Wood, JD, Robert Swidler, JD, Tia Powell, MD
2:45
Conclusion and Attendee Evaluation
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