Clinical Ethics Intensive

Welcome to the pilot training for the Clinical Ethics Intensive (CEI).  This opportunity to brings together staff from CommonSpirit hospitals to engage in training provided by the system Mission Innovation, Theology and Ethics team. Join ethicists Kevin Murphy, System Senior Vice President of Mission Innovation, Ethics and Theology and Becket Gremmels, System Vice President of Theology and Ethics in an innovative program designed to educate and enrich ethics committees and leadership.

The CEI has been approved for 12 CME Credits (3 total for 6 EthicsLab Essentials Podcasts and 9 for the Clinical Ethics Intensive live event).

There are 2 components to this training:

  1. EthicsLab Essentials Podcast
    • Listen to 6 podcasts episodes, 30 minutes each, that will provide foundational information.  These can be completed at your convenience before the start of your scheduled Clinical Ethics Intensive.
    • These episodes can be found in the Pre-Work section under Course Content below.
  2. CommonSpirit Health Virtual Clinical Ethics Intensive (held via Zoom)
    • Following the live event, please complete the Evaluation section under Course Content below.

EthicsLab Essentials – Discharge Dilemmas: Patients with Disabilities

Consider someone leaving a hospital, after their care is completed at that location, to return to their home and local community. As discharge plans are made to continue their care, their healing, their rehabilitation, are there ethical challenges that arise? Can there be biases that shape that plan because of their ability, disability, lack of family support systems or resources available in the community? What are the frameworks, tools, approaches that an assist all involved? Our guests will offer their experience in these discharge plan dilemmas and offer the practical approaches they have utilized every day.

After registration, participants pursuing CME credit must complete the following steps:

  • Step 1: review and acknowledge the EthicsLab Essentials Disclaimer and complete pre-test to evaluate participant knowledge before listening to the podcast episode
  • Step 2: listen to the EthicsLab Essentials podcast episode
  • Step 3: complete post test to evaluate participant knowledge gained after listening to the podcast episode
  • Step 4: complete evaluation

Once all steps have been successfully completed, participants are issued a PDF certificate that can be printed or saved electronically for submission to accreditation boards.

EthicsLab Essentials – Thinking Differently: Building Blocks for a Quality Ethics Program

Are there better ways to build and support a culture of clinical ethics in healthcare? What might that look like? What has worked and how could the ideas and tools offered be implemented? In the late 1990’s the idea was proposed, why not marry the work being done in health care ethics with quality improvement methodology. Would this type of “Thinking Differently” help us get traction and improve the systems and initiatives that clinical ethics tries to accomplish? These are some of the questions and issues that our guests will wrestle with as well as offering concrete examples and even practical solutions being tested today.

After registration, participants pursuing CME credit must complete the following steps:

  • Step 1: review and acknowledge the EthicsLab Essentials Disclaimer and complete pre-test to evaluate participant knowledge before listening to the podcast episode
  • Step 2: listen to the EthicsLab Essentials podcast episode
  • Step 3: complete post test to evaluate participant knowledge gained after listening to the podcast episode
  • Step 4: complete evaluation

Once all steps have been successfully completed, participants are issued a PDF certificate that can be printed or saved electronically for submission to accreditation boards.

EthicsLab Essentials – The Unrepresented Patient

Deciding for another is difficult. One of the most challenging ethical issues faced in clinical practice today is deciding for unrepresented patients – patients who have no advance directive or no family and  friends who can make decisions on behalf of the patient (surrogate decision makers) when the patient cannot speak for themselves. The moral distress of clinicians can run high especially given the diverse and complex national legal environment surrounding these patients. Our expert clinical and legal guests, experienced in the daily life of the healthcare environment, will offer insight into these challenges and offer both an overview and practical solutions being tested today.

After registration, participants pursuing CME credit must complete the following steps:

  • Step 1: review and acknowledge the EthicsLab Essentials Disclaimer and complete pre-test to evaluate participant knowledge before listening to the podcast episode
  • Step 2: listen to the EthicsLab Essentials podcast episode
  • Step 3: complete post test to evaluate participant knowledge gained after listening to the podcast episode
  • Step 4: complete evaluation

Once all steps have been successfully completed, participants are issued a PDF certificate that can be printed or saved electronically for submission to accreditation boards.

EthicsLab Essentials – Feeding Tubes

Why would the question of whether to provide food and water to a patient come up at all? One might assume it is always helpful and never harmful to offer nutrition and hydration to patients. Is that accurate? When might it be appropriate or not appropriate? Our lead contributor in this episode is Alan Sanders, Vice President of Ethics Integration and Strategy at Trinity Health is in conversation with guests in this episode to explore a number of ethical issues related to providing nutrition and hydration to patients who cannot feed themselves.

After registration, participants pursuing CME credit must complete the following steps:

  • Step 1: review and acknowledge the EthicsLab Essentials Disclaimer and complete pre-test to evaluate participant knowledge before listening to the podcast episode
  • Step 2: listen to the EthicsLab Essentials podcast episode
  • Step 3: complete post test to evaluate participant knowledge gained after listening to the podcast episode
  • Step 4: complete evaluation

Once all steps have been successfully completed, participants are issued a PDF certificate that can be printed or saved electronically for submission to accreditation boards.

EthicsLab Essentials – Brain Death – A Foundational Yet Emotional Ethical Concept

Brain death is a fundamental ethical topic that is complex and often fraught with emotion. As ethics committees are faced with considerations involving brain death, these cases are often those that stick with professionals the most. Our lead contributor in this episode Becket Gremmels, System Director of Ethics at CHRISTUS Health in Irving TX is in conversation with two nationally recognized ethicists who explore the complexities and challenges surrounding this foundational ethical concept.

After registration, participants pursuing CME credit must complete the following steps:

  • Step 1: review and acknowledge the EthicsLab Essentials Disclaimer and complete pre-test to evaluate participant knowledge before listening to the podcast episode
  • Step 2: listen to the EthicsLab Essentials podcast episode
  • Step 3: complete post test to evaluate participant knowledge gained after listening to the podcast episode
  • Step 4: complete evaluation

Once all steps have been successfully completed, participants are issued a PDF certificate that can be printed or saved electronically for submission to accreditation boards.

EthicsLab Essentials Traction – Innovative Practices Honoring Patient Wishes

Health care professionals, patients and family members could all agree that patient wishes about their care are important and need to be respected. Why then, nationally, do only 30 percent of adults have an advance directive that documents those wishes? Given that statistic, how could the town of La Crosse, Wisconsin, achieve the surprising goal that 96% of people who die there have an advance directive or similar documentation…such a difference from the national average? Some wonder how to begin such a conversation while others ask what the best systems to put in place are? Yes, there are better tools, practices and systems that can help us.

After registration, participants pursuing CME credit must complete the following steps:

  • Step 1: review and acknowledge the EthicsLab Essentials Disclaimer and complete pre-test to evaluate participant knowledge before listening to the podcast episode
  • Step 2: listen to the EthicsLab Essentials podcast episode
  • Step 3: complete post test to evaluate participant knowledge gained after listening to the podcast episode
  • Step 4: complete evaluation

Once all steps have been successfully completed, participants are issued a PDF certificate that can be printed or saved electronically for submission to accreditation boards.

EthicsLab Essentials Moral Distress and Moral Resiliency

Have you ever experienced an event, a situation or a decision where you felt that your professional integrity had been compromised? It may have occurred because of something you did, something someone else did or simply a number of events that lined up in a way that made you feel that you were between a rock and hard place. In that moment you probably experienced moral distress. In this episode, we look at moral distress in the health care environment. What are the clinical situations that cause moral distress to arise, what can be done to respond, can it be cured or is it a part of our moral life?

  • After registration, participants pursuing CME credit must complete the following steps:
    • Step 1: review and acknowledge the EthicsLab Essentials Disclaimer and complete pre-test to evaluate participant knowledge before listening to the podcast episode
    • Step 2: listen to the EthicsLab Essentials podcast episode
    • Step 3: complete post test to evaluate participant knowledge gained after listening to the podcast episode
    • Step 4: complete evaluation

    Once all steps have been successfully completed, participants are issued a PDF certificate that can be printed or saved electronically for submission to accreditation boards.

EthicsLab Essentials Beyond Capacity – Assessing Challenging Cases

One of the challenging areas in clinical practice today is wanting to honor patient wishes but not being clear on the competency or capacity level a patient with dementia or behavioral health issues. In this episode we explore different challenging situations that ask: a) What is the best assessment of capacity? b) What level of risk should be supported? c) How might health care professionals approach these situations at a deeper human level? Our guests, who are national experts in this area and will offer insight and practical consideration and approaches to the questions listed above and more.

After registration, participants pursuing CME credit must complete the following steps:

  • Step 1: review and acknowledge the EthicsLab Essentials Disclaimer and complete pre-test to evaluate participant knowledge before listening to the podcast episode
  • Step 2: listen to the EthicsLab Essentials podcast episode
  • Step 3: complete post test to evaluate participant knowledge gained after listening to the podcast episode
  • Step 4: complete evaluation

Once all steps have been successfully completed, participants are issued a PDF certificate that can be printed or saved electronically for submission to accreditation boards.

EthicsLab Essentials Do Not Resuscitate Orders

As patients, surrogate decision makers, and clinicians discuss goals of care, questions arise regarding what interventions will physiologically work and what interventions will honor the patient’s values. Do Not Resuscitate Orders are one of the interventions frequently discussed. Our lead contributor on this episode, Mark Repenshek, Executive Director for Ethics & Mission at Hospital Sisters Health System, in Wisconsin is in conversation with guests to explore a number of ethical issues related to Do Not Resuscitate orders that include, but are not limited to: a) Patient/Surrogate desires for full resuscitation despite the intervention’s lack of efficacy in specific clinical circumstances, b) Consideration of partial codes as a “compromise” co-status, c) A physicians’ professional right to limit the use of resuscitation efforts in certain circumstances.

After registration, participants pursuing CME credit must complete the following steps:

  • Step 1: review and acknowledge the EthicsLab Essentials Disclaimer and complete pre-test to evaluate participant knowledge before listening to the podcast episode
  • Step 2: listen to the EthicsLab Essentials podcast episode
  • Step 3: complete post test to evaluate participant knowledge gained after listening to the podcast episode
  • Step 4: complete evaluation

Once all steps have been successfully completed, participants are issued a PDF certificate that can be printed or saved electronically for submission to accreditation boards.

EthicsLab Essentials Informed Consent

Informed consent is one of the foundational ethical principles in health care that supports patient autonomy, or stated differently, the patients right to self-determination. More and more the standard for what clinicians should inform patients about the risks benefits and alternatives of treatment are no longer determined by what a responsible body of physicians deems important, but rather by what a reasonable patient deems important. What is needed to meet that goal is a collaborative communication process between clinicians and patients that integrates the best evidence available with the patients values and preferences to promote high quality health care decisions. In the United States at least half of the states have adopted the reasonable patient standard regarding informed consent. This episode of EthicsLab Essentials is led by lead contributor Rachelle Barina, VP – Mission Integration at SSM Health based in Wisconsin and is in conversation with two nationally known guests.

After registration, participants pursuing CME credit must complete the following steps:

  • Step 1: review and acknowledge the EthicsLab Essentials Disclaimer and complete pre-test to evaluate participant knowledge before listening to the podcast episode
  • Step 2: listen to the EthicsLab Essentials podcast episode
  • Step 3: complete post test to evaluate participant knowledge gained after listening to the podcast episode
  • Step 4: complete evaluation

Once all steps have been successfully completed, participants are issued a PDF certificate that can be printed or saved electronically for submission to accreditation boards.

EthicsLab Essentials Goals of Care

Goals of care is a term so common to health care professionals and yet, our guests describe significant clinical experiences in which the lack of discussion around goals of care led to problematic cases. A goals of care conversation is an important element at the foundation of high quality discussions around code status. In this episode lead contributor Mark Repenshek, Executive Director of Ethics and Mission at Hospital Sisters Health System in Wisconsin, is in conversation with national experts and clinicians who discuss this important topic.

After registration, participants pursuing CME credit must complete the following steps:

  • Step 1: review and acknowledge the EthicsLab Essentials Disclaimer and complete pre-test to evaluate participant knowledge before listening to the podcast episode
  • Step 2: listen to the EthicsLab Essentials podcast episode
  • Step 3: complete post test to evaluate participant knowledge gained after listening to the podcast episode
  • Step 4: complete evaluation

Once all steps have been successfully completed, participants are issued a PDF certificate that can be printed or saved electronically for submission to accreditation boards.

EthicsLab Essentials Organ Donation

The big picture is that 115,000 men, women and children await organ transplants in the United States. Even the largest football stadium in the US could not fit the number of patients on the national transplant waiting list. In 2016, 33,600 transplants brought new life to patients and their families. Since 1988, 683,000 transplants have taken place in this country.

In this episode, our lead contributor Becket Gremmels, speaks to a transplant surgeon, an ICU doctor and a health care ethicist about some of the foundational ethical approaches that honor organ donors, the patients who receive those organs, and the health care professionals who care for both.

After registration, participants pursuing CME credit must complete the following steps:

  • Step 1: review and acknowledge the EthicsLab Essentials Disclaimer and complete pre-test to evaluate participant knowledge before listening to the podcast episode
  • Step 2: listen to the EthicsLab Essentials podcast episode
  • Step 3: complete post test to evaluate participant knowledge gained after listening to the podcast episode
  • Step 4: complete evaluation

Once all steps have been successfully completed, participants are issued a PDF certificate that can be printed or saved electronically for submission to accreditation boards.