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Bioethics Expert Offers Tips

Bioethics Expert Offers Tips on Preventing and Resolving Conflicts

January's Bioethics Conference in the Harvey Morse Auditorium explored an important issue facing caregivers -- What is the best way to handle situations when families disagree about patient treatment?

Leading the discussion was Carol Taylor, R.N., Ph.D., Director of Georgetown University's Center for Clinical Bioethics. Experienced in caring for patients who are chronically and critically ill as well as their families, Taylor works closely with healthcare professionals who are exploring the ethical dimensions of their practice.

Strategies to prevent or resolve conflict, according to Taylor, include:

  • Establish Common Objectives at Start of Care -- learn how to say to patients and families: "Our common objective is to discover which of the options in front of us is most likely to secure the interests and well-being of the patient."
  • Establish Ongoing, Honest Communication
  • Assign Clear "Point People" -- on both caregiver and patient family side
  • Create a coversheet for the patient's chart, which is reviewed weekly to determine the need for a patient care conference
  • Have regular mechanism for interdisciplinary patient care conferences
  • Clarify expectations related to treatment at the outset (for the patient, family and all members of professional caregiving team)
  • Mediation of conflict should be core competency for all bedside physicians
  • Hold regular debriefings with members of the professional caregiving team and family members
  • Create safe places for professional caregivers to vent

Cedars-Sinai has an active Center for Healthcare Ethics and a Bioethics Committee that includes more than 50 individuals representing the medical staff, nursing, social services, chaplaincy, administration, legal and lay community. A bioethics consultation may be requested 24 hours a day, seven days a week by a patient, the patient's family or any member (or members) of the patient's healthcare team. The consultation is held to help discuss, clarify and resolve moral dilemmas that arise in caring for a patient.

Kenneth Leeds, M.D., Interim Director of Cedars-Sinai's Center for Healthcare Ethics, reminds staff that Cedars-Sinai has a new policy (EBE00040, effective January 2007) which provides guidelines in caring for adult patients in the ICU identified to be at the "End-of-Life."

(Click here to view a PDF version of the policy.)

"The new policy is meant to encourage continued communication between caregivers and patients' families," said Dr. Leeds.

For more information, please call the Center for Healthcare Ethics at (310) 423-9634.