HEALTH CARE PROFESSIONALS
In 2003 and 2004, there were a number of new educational initiatives
worthy of highlighting:
• The Citywide Ethics Case discussion series was developed
to bring together persons interested in clinical ethics for
informal discussion on cases and consultation issues. This is
a colloborative effort of the Department of Bioethics at CASE,
the Department of Bioethics at the Cleveland Clinic Foundation,
the Clinical Ethics Program at the University Hospitals of Cleveland
and the Clinical Ethics Program at MetroHealth Medical Center.
Case discussions are held monthly and rotate between three sites
(UH, CCF and MetroHealth Medical Center).
• Several difficult ethics consultations led to the implementation
of monthly multidisciplinary ethics rounds for care providers
in the NICU, with the aim of affording a forum for: (1) the
discussion of ongoing difficult cases and (2) addressing particular
topical concerns with ethical and/or pastoral care dimensions.
• A six week ethics lecture series was offered twice for
the annual MetroHealth System Neonatology, Physiology and Pathology
Ethics Conference. In January 2004, this series was offered
as a Perinatology Conference for Northeast Ohio medical professionals.
Sessions included:
o The Relevance and Role of Ethics (Mark P. Aulisio, PhD)
o Ethical Standards for Decision Making (Mark P. Aulisio, PhD)
o Pediatric Hospice (Mary K. Tyler, NP; Hospice of the Western
Reserve)
o Ethical Issues Surrounding “Viability”(Kathryn Weise,
MD; CCF)
o Coercion or Empowerment: Dilemmas in “Informed Consent”?
(Kathryn Weise, MD; CCF)
o End of Life Decisions with Newborns: Ethical and Legal Issues
(Mary Legerski, JD)
• Bimonthly ethics education series was done for the Pastoral
Care Department. Sessions included:
o Relevance of Ethics for Clinical Practice (Mark P. Aulisio,
PhD)
o Informed Consent, Patient Autonomy and Faith Communities (Mark
P. Aulisio, PhD)
o Competence in Context (Mark P. Aulisio, PhD)
o Patient in the Middle: End of Life Decisions and the Role
of the Family (Mark P. Aulisio, PhD)
o Confidentiality (Mark P. Aulisio, PhD)
• BiMonthly OB/Peds Management Conferences were devoted
to discussing ethical issues raised by particular cases (presented
by a Fellow and Dr. Aulisio)
The Clinical Ethics Program has also offered or participated
in the following selected educational sessions for health professionals
and others at MetroHealth, CWRU and outside the MHS system:
• Pediatric Grand Rounds, “Having a Child to Save
a Child,” January 17, 2003. (Aulisio)
• Pediatric Grand Rounds, “Ethical Issues in the
Care of Multi-Handicapped Children,” February 21, 2003.
(Weise)
• Medicine Noon Conference, “End of Life Decisions
and the Role of the Family,” March 7, 2003 (Aulisio)
• Pediatric Noon Management Conference, “Ethical
Issues for Residents, March 26, 2003 (Weise)
• Pediatric Noon Management Conference, “The Technology
Dependent Child: Beyond Game-Boy,” April 23, 2003 (Weise)
• Surgery Management Conference, “Futility in Surgery,”
May 29, 2003 (P. Ford, PhD; CCF)
• Pediatric Grand Rounds, “Growth Hormone for Non-Growth
Hormone Deficient Children,” June 6, 2003 (Norm Fost, MD;
University of Wisconsin)
• Ethics for Social Workers, 2 half-day sessions, September
10, 2003:
o Relevance of Ethics for Social Work (2x)
o Centrality of Informed Consent in Medical Decision Making
(2x)
o End of Life Decisions: Nuts and Bolts for SW (2x)
• “Ethics and Psychology Seminar,” Cleveland
Psychological Association, November 11, 2003 (Aulisio)
• “Hard Cases, Good Dialogue: French and American
Persepectives on End of Life Decisions,” University of
Paris, School of Medicine, Department of Bioethics, January
2004. (Aulisio)
• “Minimal Risk, Maximal Quandary: Ethical Dilemmas
in Human Subjects Research,” The College of Wooster, March
2004 (Aulisio)
• “The Future of Bioethics as a Field,” National
Undergraduate Bioethics Conference, Life Sciences and Society
Program, University of Michigan, Ann Arbor, Michigan, March
2004 (Aulisio, Peter Ubel and Susan Goold)
• “Implanted Cardiac Devices and End of Life Decisions,”
Heartbeats Fast & Slow, 17th Annual Meeting of NEOSPE, Cleveland,
Ohio, September 2004 (Aulisio and Donna Luebke)
• “Minimal Risk, Maximal Quandary: Ethical Dilemmas
in Human Subjects Research,” Medical College of Ohio, Toledo,
Ohio, September 2004 (Aulisio)
• “Minimal Risk, Maximal Quandary: Ethical Dilemmas
in Human Subjects Research,” SRA International Annual Meeting,
Salt Lake City, Utah, October 2004 (Aulisio)
Medical Ethics Committee Education
• Ethics Committee educational outreach for 2004 focused
on the theme of medical futility. This 1-hour educational session
was held in many areas of the MHMC, including: Medicine, Nursing,
and Social Work. This session was also give outside the MHS
in 2003 for:
Mark P. Aulisio, “End of Life Decisions and Medical Futility:
Who Should Decide?” Aurora Sinai Medical Center and the
Midwest Ethics Committee Network, Milwaukee, Wisconsin, May
2003.
• Ethics Committee educational outreach for 2003 focused
on the theme of dealing with chronically non-compliant patient.
A subcommittee of the ethics committee developed guidelines
for dealing with chronic noncompliance. Mark Aulisio, ethics
committee chair, then developed a one-hour ethics education
session around these guidelines. This educational session was
held in many areas of the MHMC, including: Medicine, Nursing,
Social Work, Psychiatry, Physical Therapy and Surgery. It was
also given outside the MHS for :
Mark P. Aulisio, “Chronic Noncompliance and Advanced Practice
Nursing,” Advanced Practice Nursing: Keys for Success,
Annual Conference on Advanced Practice Nursing, Eastlake, Ohio,
April 2003.
Mark P. Aulisio, “Guidelines for Frequent Fliers: Dealing
with Chronically Noncompliant Patients,” Medicine Grand
Rounds, Cleveland Clinic Foundation, December 2002.
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