Difficult Decisions in Clinical Practice: Clinical Ethics Speaker Presentations
Chaired by Christopher Fincken, Chair, The UK Council of Caldicott Guardians this conference took a practical approach to managing difficult decisions in clinical practice through applying the principles of clinical ethics.
The conference took a case study approach and enabled delegates to develop a structured approach to ethical decision making in clinical practice. Case studies looked at Integrating ethical decision making into everyday clinical practice, principles and practice of Ethical Decision Making, how clinical ethics relates to the law, confidentiality and the role of the Caldicott Guardian, Decision making for patient choice, autonomy and best interests, refusal of treatment, a framework for ethical decision making, clinical ethics in safeguarding and clinical ethics at the end of life.
Dr Stephen Louw, Consultant Physician and Chair, Clinical Ethics Advisory Group, former Clinical Director for Medicine and Older People’s Medicine, Newcastle upon Tyne Hospitals NHS Foundation Trust, Board Member (former Chair), UK Clinical Ethics Network opened the conference with an extended session on ‘Integrating ethical decision making into everyday clinical practice: Principles and practice of Ethical Decision making’ in his presentation Dr Stephen Louw discussed:
- the most commonly used moral theories and principles will be briefly rehearsed.
- the heart of the talk is a description of the process of moral reasoning - deductivism will be contrasted with casuistic reasoning. Two examples were discussed to illustrate the process of casuistic reasoning. The overlap of casuistry with Court judgments was also exemplified.
- a number of steps that may typically be taken to achieve ‘ethical decision making in everyday hospital practice’ will be listed and discussion invited.
Dr Louw lead a discussion on "why is it important to be confident in ethical analysis, with a focus on always being able to justify your decision"
Dr Stephen Louw trained at the University of Cape Town Medical School, his early career in chest and ITU medicine triggered an interest in the ethics of resource allocation and withholding and withdrawing ITU treatment. In 1992 he changed direction to Geriatric Medicine. He moved to the Newcastle upon Tyne in 1998, where he co-established the stroke service. In 2001 he founded his trust’s Clinical Ethics Advisory Group which he continues chair. Dr Stephen Louw contributed to establishing the UK Clinical Ethics Network, and was national chair for two years. He has organized two UKCEN conferences in Newcastle and contributes to both postgraduate and undergraduate courses and lecture series in ethics. In collaboration with colleagues he has published articles on ethics and co-edited a book on the key ethical and philosophical aspects of dementia.
Dr Stephen Louw, Consultant Physician and Chair, Clinical Ethics Advisory Group, former Clinical Director for Medicine and Older People’s Medicine, Newcastle upon Tyne Hospitals NHS Foundation Trust, Board Member (former Chair), UK Clinical Ethics Network Full Presentation Click Here
Following Dr Stephen Louw, Dr Franco Moscuzza, Board of Trustees, Clinical Ethics Network and Consultant Anaesthetist, Guy’s and St Thomas’ NHS Foundation Trust gave a case study presentation on ‘Decision making: patient choice, autonomy and best interests’ and discussed:
- decision making, patient choice and autonomy
- the clinicians role to inform decision making
- case study: refusal of consent
Dr Mosuzza looked at how the law has changed over the last 58 years with regards to ethics.
Dr Franco Moscuzza was appointed as a Consultant Anaesthetist with a special interest in Paediatric Cardiac Surgery to Guy's and St Thomas' NHS Foundation Trust in 1998. He was a member of the Guy's Hospital Research Ethics Committee prior to completing an MA in Medical Ethics & Law in 2007. Following this he was a founder member of the Trust Clinical Ethics Committee which he chairs. He sits on the Board of Trustees of the UK Central Ethics Network and edits the newsletter. He regularly lectures on Clinical Ethics and decision-making to a range of clinical audiences.
Dr Franco Moscuzza, Board of Trustees, Clinical Ethics Network and Consultant Anaesthetist, Guy’s and St Thomas’ NHS Foundation Trust Full Presentation Click Here
Following the morning break the conference continued with presentations on ‘The relationship between legal and ethical issues’ and ‘Support for difficult decisions: Developing the role of the Clinical Ethics Committee’.
Christopher Fincken, Chair, The UK Council of Caldicott Guardians open the afternoon session with a presentation on ‘Ethical decision making, confidentiality & information sharing: The role of the Caldicott Guardian’ and discussed:
- current ethical issues for the Caldicott Guardian
- ethical decision making and managing disagreement between Caldicott Guardians
- ethical decision making around breaching confidentiality to protect others
- moving forward: current and future issues
Christopher stated that "there are fundamental differences between Information Governance and Caldicott. IG = can you do it legally and how? Caldicott = Should you do it?" "All NHS organisations have to have CG, as do armed services and charities". "The CG is to the gatekeeper to the patients information and the conscience of the organisation"
Future events of interest:
A Practical Guide to applying and monitoring adherence to The Duty of Candour
Expert Witness Intensive Training Course: 2 Day
27 January 2016