Ethical Issues Surrounding Long-Term Care

November 3, 2015

Bermuda Hospitals Board [BHB] staff members are spending this week focusing on medical ethics, particularly the ethical issues that arise in long-term care situations.

From 2-7 November medical ethics expert Dr Christy Simpson, head of the Bioethics Department at Dalhousie University in Halifax, will work with staff at King Edward VII Memorial Hospital [KEMH] and the Mid-Atlantic Wellness Institute [MWI].

Together they will take the basic principles of medical ethics and explore how they can be applied to long-term care.

From Monday to Thursday, medical staff and community partners are attending seminars, continuing education sessions and grand rounds. On Friday and Saturday, Dr Simpson will lead a symposium for members of BHB’s Ethics Committee.

The public is invited to visit the lobbies at MWI and the KEMH Acute Care Wing and General Wing throughout the week to learn more about ethics at BHB and about this year’s Ethics Awareness Week topic, The Ethics of Long-term Care: What matters in the end.

Dr Sharon Alikhani, Ethics Committee chair and director of palliative care, said: “With an ageing population worldwide, long-term care is an increasingly relevant topic. But it’s not only the elderly who need this kind of care. Our younger adults with physical or learning disabilities, early onset dementia or other enduring illnesses may also need long-term support.

“There are community resources that can help some individuals maintain their independence rather than requiring residential care,” Dr Alikhani continued. “These clients, their families and their service providers may also run into ethical issues surrounding their medical care and life decisions.”

Dr Chantelle Simmons, chair of the Ethics Education Subcommittee and chief of Psychiatry, added: “Ethics is about making decisions based on a shared understanding of right and wrong. It’s about doing the right things for the right reasons.

“Some of the ethical dilemmas those involved in long-term care might face include questions around whether an individual has the capacity to make decisions about their care, living situation, lifestyle or finances,” Dr Simmons said. “For those who are seriously ill, ethical questions may arise about end-oflife decisions like advance directives, feeding and life support.”

The BHB Ethics Committee offers assistance to clients, their families and healthcare professionals who are dealing with ethical issues around medical care. Members of the public can contact the Ethics Committee for a consultation by calling 291-HOPE [4673].

The BHB Ethics Committee is comprised of about 20 members, including clinical, administrative and community representatives.

The Committee promotes awareness of ethical concerns at both hospitals, endorses medical ethics education, provides an ethics consultation service and produces guidelines on prominent issues that can help healthcare professionals consider all aspects of controversial decisions.

The Committee also reviews medical research proposals on request, and reviews hospital policies to ensure they are ethically sound.

More than a decade ago, BHB’s Ethics Committee formed a relationship with Dalhousie University’s Department of Bioethics, which continues to provide assistance and training in ethical matters.

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