One of the most difficult problems facing hospitals and health systems today is scarcity of key medical resources. Unfortunately, blood product shortages are not uncommon, and they present significant challenges for patient care. Our guests in this episode developed a specific set of recommendations and a protocol for their hospitals to deal with these situations. They’ve also worked to establish a standard approach across their geographic region, which a lot of locations have not really been able to accomplish. We hope their insights and work can inform other ethicists, hospitals and cities ..read more

When you hear the phrase quality of life, what comes to mind? Having dinner with family, learning a language, watching a movie with friends? Or, does the image of a patient struggling to perform basic tasks such as bathing or getting dressed, or someone who is reliant on a ventilator to breathe come to mind? Despite its inherently subjective and multifaceted nature, quality of life is a term that is widely used in healthcare, particularly for making critical decisions that have life-altering consequences. It is a complex construct that encompasses a wide range of factors that affect a person ..read more

What type of influence should physicians, nurses and patients have on tough choice healthcare decisions? Clinicians want to offer their experience and their competence, so should they be neutral and simply support patient decisions? What type of influence would be helpful and what type would be inappropriate, coercive, or biased? In this episode, our guests explore these questions and a behavioral economics tool called “nudging”. Nudges are subtle changes to the design, framing of information, and decision options that can influence behaviors. These subtle changes, stemming from decision psyc ..read more

In March 2020, the coronavirus pandemic created a devastating impact within and outside the United States. COVID-19 made us painfully aware of systemic racism in healthcare with the allocation of scarce resources for vulnerable populations. In May 2020, the murder of George Floyd by a police officer brought the continued injustice of systemic racism into sharp focus for many Americans. The nation’s focus on confronting systemic racism highlighted foundational questions of bias against people of color in public health ethics and bioethics regarding providing fair and equitable responses to the ..read more

If primary health care professionals are to serve and accompany the transgender community well, what would that look like? What would need our attention? What approaches have proved helpful and supportive? What would accompaniment require from health care professionals? Our guests today are either health professionals who are transgender or who have devoted their professional lives to serving the transgender community. Our guests in this episode include: Shane Snowdon, past/founding director of the National Center for LGBTQ Health and Equity at UC San Francisco, past/founding director of the ..read more

Offering a composite picture of someone with a drug addiction is not easy. It is not specific to gender, age, income, education, ethnicity, or geography. In this second episode on addiction and medically supervised injection rooms, we go to Melbourne Australia and speak to health care leaders there, on their experience with these programs. Again, these programs aim to a) respond to the addiction health issues of those who are dependent on injection drugs, and b) respond to the broader public health impact of addiction on a community, such as a high amount of drug overdose or the transmission ..read more

Harm reduction programs like needle exchange programs or medically supervised injection sites aim to a) respond to the addiction health issues of those who are dependent on injection drugs, and b) respond to the broader public health impact of addiction on a community such as a high amount of drug overdose or the transmission of infectious disease through the sharing of infected needles. These harm reduction programs are having an impact, but some have questioned whether such programs inappropriately cooperate with drug abuse. Our two guests today will offer us insight into that question and ..read more

Today, tough choice healthcare ethics dilemmas are discussed by patients, their loved ones and health care professionals. These discussions are about the care and treatment plan of the patient based on their values. Most often these discussions and decisions have been held in person. As healthcare moves to virtual care, especially in our current COVID19 environment, what would virtual ethics discussions or consultations look like? What would be important to pay attention to? Our guests today have offered such virtual ethics discussions on tough choice decisions with patients. Our guests in th ..read more

Street Medicine is local and international. In this second episode on Street Medicine we hear about health care leaders in Portland, Oregon responding to the needs in their community. The challenge? Nationally, Oregon has the fourth highest rate of homelessness and the second highest rate of families without shelter. In recent years Portland’s chronic homelessness has increased at twice the national rate. The homeless population is growing older, more disabled, and is on the streets for longer periods of time. The homeless in any community face stigma, social isolation, and loss of relationsh ..read more

Those who work on responding to the ethical issues and decisions that arise in healthcare realize that we are invited into the most complex stories that patients, families , healthcare professionals and our communities have to offer. They not only involve value-laden clinical decisions about patient treatments, but community decisions about public health that sometimes […] The post The Work: Reflections of Two Healthcare Ethicists appeared first on Mission Network ..read more