In the spring of 2014, Creighton’s Center for Health Policy & Ethics launched Bioethics Beyond the Bedside, a podcast series exploring ethical dilemmas outside the hospital setting. The podcasts provide health care professionals and the community at large a platform to learn about the importance of ethics in outpatient settings. Below are summaries of the most popular episodes to date.
Episode #1: "Ethical Challenges in the Outpatient Setting"
February 26, 2014
In the inaugural episode, Dr. Amy Haddad discusses the intent behind the Bioethics Beyond the Bedside podcast series and expresses her hope that it will serve to educate clinicians, patients and the general public on ethical issues that can arise in outpatient settings. In contrast to traditional acute care settings, dealing with ethical issues in outpatient settings can be more challenging and often more difficult to identify. Home care’s increased reliance on the patient’s family and community members means that a larger group of people may be part of the decision making process. As noted by Dr. Haddad, ensuring proper communication, planning, and resource allocation are all essential when attempting to overcome these challenges.
Episode #2: "Ethical Perspectives from a Primary Care Physician"
March 13, 2014
In this episode, co-host and primary care physician Dr. Mark Goodman of Creighton University’s School of Medicine talks about ethical issues he encounters in his role as a family physician. Frequently, making an ethical decision requires medical professionals to shed their inherent desire to be “people pleasers.” Doctors receive a host of questionable requests from their patients that, if fulfilled, would constitute a breach of ethics. At times, physicians may also find the most ethical decision at odds with current laws and regulations. When faced with these issues, Dr. Goodman recommends that clinicians let the Hippocratic Oath and their own personal mission statement guide their decision making.
Episode #14: “Challenges and Opportunities at the End of Life”
September 11, 2014
Dr. Helen Chapple, associate professor at the Center for Health Policy & Ethics, talks about health care ethics relating to end of life care and her professional experience with the topic. As noted in the discussion, some aspects of end of life care have improved over the years. For example, the number of hospices has increased, and far fewer people are dying in hospitals. However, many challenges remain. At the root of these challenges are a cultural unwillingness to have constructive dialogue about end of life care and an attachment to overly optimistic outcomes. While our healthcare professionals possess advanced knowledge and technology, the inevitability of death and its circumstances still require extensive thought and planning. Put simply, it is important for medical professionals and patients alike to hope for the best and prepare for the worst.
Episode #24: "Decision-making in Maternal Fetal Medicine"
February 13, 2015
Dr. James Smith, a physician and educator in the School of Medicine at Creighton University, provides insight into ethical issues relating to his area of specialty, perinatology. According to Dr. Smith, the nature of high-risk pregnancies and the issues surrounding them have shifted over time. For example, 30 years ago, the kinds of discussions about rendering care for a fetus at 28 weeks are now reserved for those at 22-23 weeks. Even as the ability to care for premature births has improved, the pressure to improve outcomes is constant. In this kind of environment, many things complicate the ethical decision making process. Caregivers must appropriately support the patient but be clear about expectations. Additionally, they must differentiate between perceived urgency and artificial urgency. Dr. Smith recommends that clinicians approach each situation with sensitivity and knowledge in order to connect with each patient and ensure the best result.
Episode #25: "Myths and Biases in Pain Management"
February 26, 2015
Dr. Charles Youngblood is an anesthesiologist and expert in pain management at Creighton University. In this podcast, Dr. Youngblood identifies a number ethical issues related to the treatment of pain. Primarily, it is important to recognize that pain tolerance is very subjective. A caregiver should rely on the patient’s own perception of pain severity and avoid bringing their own biases into the decision making process. Often, stereotypes can affect the quality of pain treatment a patient receives. Among other challenges, anesthesiology professionals must also overcome an abundance of misinformation. Contrary to conventional wisdom, the probability of a patient becoming addicted to pain killer is actually quite low. Likewise, the safety of epidurals is often called into question, even though it’s proven to be an effective way to minimize labor and delivery pain. As Dr. Youngblood points out, a patient should view themselves as the best advocate for their care. The ideal way to avoid misinformation and understand which pain modalities are most effective for a particular person is to ask questions.
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