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 this episode include:

• Cristie Cole-Horsburgh, lawyer and staff ethicist with the Cleveland Clinic, Center for Bioethics
• Dr. Mahwish Ahmad, physician and transplant ethicist with the Cleveland Clinic, Center for Bioethics

This episode was recorded on March 4, 2020

Resources referenced in this episode:

• Cleveland Clinic Center for Bioethics Virtual Ethics Consultation

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A 2019 White House Report tells us that half a million people are homeless each night in the UnitedStates.In 1992, Dr. Jim Withers began doing street rounds in Pittsburgh, Pennsylvania, bringing medical care to the homeless. Since that time the Street Medicine Institute he founded has grown to become international organization. In 2015, CNN named Dr Withers as one of their “Top Ten Heroes.” How might healthcare best include and serve people living without any shelter?

This episode was recorded on March 16, 2020

Resources referenced in this episode:

• The Street Medicine Institute
• American College of Physicians – Dr. James S. Withers, MD, FACP, on 26 years of treating the homeless and living by the motto, “Go to the people.”
• CNN -Top 10 CNN Hero Dr. Jim Withers

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On March 11, the World Health Organization (WHO) declared COVID-19 a pandemic, pointing to the over 118,000 cases of the coronavirus illness in over 110 countries and territories around the world and the sustained risk of further global spread. To discuss some of the ethical issues regarding COVID-19 we are joined by Dr. Ken Iserson and Becket Gremmels. This episode was recorded on Friday March 20, 2020.

Our guests in this episode include:

• Dr. Ken Iserson, Professor Emeritus of Emergency Medicine at The University of Arizona, Medical Director (Emeritus) of the Southern Arizona Rescue Association (search & rescue), a Supervisory Physician with Arizona’s Disaster Medical Assistance Team (AZ-1), and a member of the American Red Cross disaster response team.
• Becket Gremmels, System Director of Ethics for CHRISTUS Health based in Irving, Texas. CHRISTUS Health can be found in 60 US cities and is comprised of 60 hospitals and long-term care facilities, as well as 175 clinics and outpatient centers.

Additional resources relating to or referenced in this episode:

• Improvised Medicine: Providing Care in Extreme Environments, Ken Iserson
• Joint Statement on Multiple Patients Per Ventilator
• Must I Respond If My Health Is at Risk, Ken Iserson
• Triage in Medicine, Part II-Underlying Values and Principles, John Moskop and Ken Iserson

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As we look back on 2019 and forward to 2020, our guests are editors of key healthcare ethics journals with an international readership:

• Gregory E. Kaebnick, Editor, The Hastings Center Report
• Leslie LeBlanc, Managing Editor, Journal of Clinical Ethics
• Nate Hibner, Primary Editor, Health Care Ethics USA and Director of Ethics at the Catholic Health Association of the United States

What are the issues in health care ethics that are impacting ethics committees, health systems, public policy and patients over the past year? What issues do they expect to continue and emerge within the next year? What are they hearing from authors and readers? What key articles published in their journals published in the last year might they recommend to you, our listeners? We explore these questions and more in this episode of EthicsLab.

Additional resources relating to or referenced in this episode:

• Of Slide Rules and Stethoscopes: AI and the Future of Doctoring, Robert D. Truog
• Patient as Gift, Lydia Dugdale
• Changing the Question, Daniel Brudney
• The Inner Life of Ethicists: The Importance of Cultivating an Interior Life, Paul J. Waddell
• Ethics and Medical Standards of Care: Hysterectomy, Tubal Ligation or Salpingectomy?. Sr. Patricia Talone and Amy Warner

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New research findings regarding HIV status will impact how we understand and practice disclosure of HIV status of patients… specifically whether or not to disclose a sick patients’ HIV serostatus to their family or partner. The new research demonstrates that when an HIV-positive person sticks to their treatment, their HIV is undetectable and untransmittable (U=U). Our three guests are working together on bioethical projects to spread the awareness of U=U.

Our guests in this episode include:

• Jamie Crist, JD, MA a Clinical Ethics Fellow at the Baylor College of Medicine, Houston Texas and doing clinical ethics consultation at Houston Methodist Hospital. Jamie has a JD and Masters in Bioethics at Case Western University.
• Nicole Meredyth, MD, is a clinical ethics fellow at Weil Cornell Medicine in New York Presbyterian Hospital. She is also completing her surgical residency at Weil Cornell University.
• Nekee Pandya, MD; is a clinical ethics fellow at Weil Cornell Hospital and also a hospitalist at that hospital.

Additional resources relating to or referenced in this episode:

• HIV Law and Policy
• CDC HIV Treatment as Prevention
• HIV viral load and transmissibility of HIV infection: undetectable equals untransmittable

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