COMMUNITY OUTREACH
Every year the Clinical Ethics Program offers a number of community
outreach programs and initiatives. Two recent efforts included:
Community Outreach - 2004
The Clinical Ethics Program's major community outreach initiative
for 2004 was the "HIV positive adolescent committee."
This committee was created in 2003 as an inter institutional
committee for discussion and review of the management of HIV
positive adolescent patients. This committee is a project of
the Clinical Ethics Program at MetroHealth Medical Center and
the Department of Bioethics at the School of Medicine at Case
Western Reserve University. This committee is inclusive of the
three academic teaching institutions in Cleveland – MetroHealth
Medical Center, University Hospitals of Cleveland and The Cleveland
Clinic Health System. We are also pleased to have the participation
of The AIDS Task Force of Greater Cleveland and The Free Medical
Clinic of Greater Cleveland. The mission for this multidisciplinary
committee is to provide optimal consultation and care to adolescent
patients living with HIV.
Meetings have been held regularly in 2004 to begin the process
of shaping the committee’s efforts and focus. Our intention
is to develop the first consultative body among the major providers
in northeastern Ohio for this special population. This committee
has convened to provide ongoing dialogue with respect to: informal
discussion and case consultation to identify and review the
many complex issues inherent in caring for HIV+ adolescent patients;
determining policies to ensure best practices for case management;
and service as an educational resource for those working with
this population. The committee will continue to meet quarterly
in 2005.
Community Outreach - 2003
The Clinical Ethics Program’s major community outreach
initiative for 2003 was the “Clinical Ethics and Ministry
Project: Practical Resources for Spiritual Caregivers.”
This project provided persons in ministry from Northeast Ohio
with education and experience in clinical ethics allowing them
to become more effective advocates, advisors, and enablers for
their parishioners within the context of their own faith traditions.
Clergy are an untapped resource to help citizens throughout
Northeast Ohio in this arena. This was, to our knowledge, the
first such program, and, could potentially serve as a national
model. During the first (February 14, 2003 to March 21, 2003)
and second (October 17, 2003 to November 21, 2003) six-week
pilot run of the Clinical Ethics and Ministry Project, the following
was achieved:
• Twenty participants represented ten different faith
traditions (Presbyterian, Catholic, Unitarian, Baptist, Methodist,
Episcopal, Apostolic, Jewish, Non-Denominational and Muslim).
In addition, three members of the advisory committee participated
in the initial pilot. Participants varied in their previous
experience in the clinical setting.
• Each six-week pilot session featured six didactic seminars.
Informational packets were created to correspond to these seminars
and included the lecturer’s Power Point slides (where applicable)
and suggested reading to supplement the seminars. The 2 hour
didactic seminars were taught by Case Western Reserve University
Department of Bioethics faculty. Sessions included: Informed
Consent, Patient Autonomy, and Faith Communities (Mark P. Aulisio,
PhD); Decision Capacity and Competence (Stuart J. Youngner,
MD); Spirituality and Health (Elizabeth D. McKinley, MD); Ethics
and Dementia (Stephen G. Post, PhD); What is Palliative Care?
(Elizabeth O’Toole, MD); and End of Life Decision-Making:
A Moral Framework (Mark P. Aulisio, PhD).
• Each six-week pilot seminar featured a clinical component
designed to expose participants to ethical issues in the clinical
setting. The clinical component consisted of three or four two-hour
guided observation and discussion sessions. The clinical sessions
occurred at St. Vincent Charity Hospital or MetroHealth Medical
Center. The clinical sessions were drawn from different clinical
areas, including: General Medicine & Intensive Care Unit
(ICU); Neonatal Intensive Care Unit (NICU); Pediatric Intensive
Care Unit (PICU); Surgical Intensive Care Unit (SICU); and the
Ambulatory Medicine Clinic.
• Participants also shadowed a member of the Pastoral
Care team. The three-hour Pastoral Care component consisted
of an overview of the activities of the Pastoral Care Team at
either St. Vincent Charity Hospital or MetroHealth Medical Center.
• Participants also were exposed to the hospice care setting.
The two-and-a-half hour Hospice component consisted of an overview
of hospice philosophy and tour of Hospice House at the Hospice
of the Western Reserve.
• The participants were asked to fill out an evaluation
form at the end of the last didactic seminar for each pilot.
Responses overall were very favorable.
Other Community Outreach for 2003 and 2004 Included:
• Dawn Alpaugh Smith, “Clinical Ethics,” Science
and Societal Issues Symposium for High School Students, Case
Western Reserve University Department of Bioethics, March 22,
2003.
• Both Mark Aulisio and Dawn Alpaugh Smith are community
representatives to the Kethley House nursing home Ethics Committee.
In 2003 and 2004, the Kethley House ethics committee met regularly
to discuss and develop an in-house ethics committee policy and
guidelines. The committee also developed educational sessions
for the ethics committee, Kethley House and the local community
in 2004. This committee will continue to meet in 2005.
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