Two education sessions were held on the topic 'Family Conflict about Tube Feeding Decisions'. These sessions were well attended by staff at both sites. The sessions were lead by Ed Long, Pastoral Care, Port Arthur site, Lynne Gray Sihvonen, Professional Practice Leader and Dr. R. Berg, Lakehead University.
The discussions focussed on the following hypothetical case. Mrs. Smith is a 76 year-old who has been a resident for 5 years in an Alzheimer's ward of a long-term care facility. She is a widow with several children and grandchildren. About 5 days ago she suffered an acute stroke and remains on a medical ward of an acute care hospital. She is awake but paralyzed and unable to speak.
Mrs. Smith's chart contains a DNAR order to which she consented several years ago.
The children and grandchildren of Mrs. Smith are in disagreement about whether or not to insert a feeding tube into her stomach and feed her through this tube. Two children have stated that they want "everything done" and they don't want to see their mother "starve to death". The other two children state that their mother's wishes should be followed and she should be allowed to "die in peace".
Questions used in the discussion were:
- What are the ethical issues in this case?
- How would you deal with the issues?
- What is the relative importance of respecting the patient's wishes compared with those of the disagreeing family members?
- How would we mediate or decide among the disagreeing family members?
DISCHARGE
The next topic to be discussed at the TBRH Ethics Roundtable will be 'Discharge'. Watch for posters announcing the date and time.
ETHICS TEAM OBJECTIVES FOR 2001 - 2002
The Ethics Team established objectives for 2001 - 2002. These objectives are being used to guide the topics that are discussed that the monthly meetings.
Educational opportunities for team
- Sharing web sites that are of interest
Communicating with Staff
- Developing a web site
- Publishing a newsletter
Holding staff education sessions
- Organizing Roundtable discussions for Family conflict over Tube Feeding, Discharge, and DNAR.
Review existing Codes of Ethics for Healthcare Professionals
- Develop a better understanding of these codes and how they affect delivery of care.
Review existing departmental policies
- Discussing DNAR, Hydration and Withdrawal of Tube Feeding.
TOPICS FOR DISCUSSION
Do you have topics that you would like to suggest the Ethics Team discuss either at its meeting or at a Roundtable Discussion? Suggestions are welcomed. Contact S. Hamilton or Dr. J. Kotalik (for contact numbers see front of newsletter).
ETHICS TEAM MEMBERSHIP
The Ethics Team is looking for staff participants. Meetings are held on the second Friday of each month at 0800 to 0930 hours. If you are interested contact either of the team leaders, Dr. J. Kotalik or S. Hamilton (for contact numbers see front of newsletter).
COMING SOON
Do Not Attempt Resuscitation Policy
The policy is in the approval process now, and following final approval you will see posters outlining the new policy as well as date and time for education sessions.
Center for Health Care Ethics
November 14, 2001
Ethical Dilemmas of Physician and Patient in Genetic Practice
Speaker: Dr. Judith Alanson
Children's Hospital of Eastern Ontario,Ottawa
Chair: Dr. Jane Taylor LU
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