Measuring the Value of Ethical Frameworks
A central focus of our work at Canmore Ethics is thinking about how organizational processes influence outcomes. We regularly find that when ethical issues occur, it’s not because of bad people acting negligently, but because the organization had no process for identifying and addressing ethical risk. Different tools exist for correcting this gap. One is a code of conduct; another is an ethics framework. Both of these are useful, but their value can be exaggerated. We have already explored the limits of codes of conduct in a previous article. Here, we discuss ethical frameworks.
How An Ethics Board Can Help Your Company
Data concerning aspects of our lives, including our health, is regularly collected by companies and healthcare systems. Since lax data protection policies can severely impact people, protecting that data is important for both ethical and business reasons: it will promote the safety and well-being of customers, and it will ensure that the company maintains trust with its users. However, identifying and addressing all of the relevant ethical issues can be daunting. One strategy is to adopt a research ethics board (REB) model.
Improve Decision-Making by Thinking Explicitly About Values
Ethical decision-making involves explicit recognition and consideration of ethical values: things like liberty, equality, well-being, and privacy. For many organizations, one of the most effective ways to make more ethical decisions is simply to be more explicit about the role values play.
How Leaders Shape Ethics
No matter your field of work or place of business, the ethical behaviour and conduct of your peers and employees is important to ensure the success of your company. Research demonstrates that the effects of both ethical and unethical behaviour are often larger than we might realize.
Improving Advance Directives with Video
In the opening scene of Annie Hall, the film’s main character tells a joke about two elderly women who are lamenting the decline of a restaurant. The first woman says “‘Boy, the food at this place is really terrible.’ The other one says, ‘Yeah, I know. And such small portions.’” If you’ll permit a health ethics joke, a similar lament applies to advance directives: They’re unhelpful and too few people have them.
This insight article describes some of the shortcomings of written advance directives and explains how making videos to accompany the legal document can help ensure patients receive the care they want.
Going Beyond the Code of Conduct
Compliance programs are an essential part of healthcare organizations. There are many predictable situations that employees might find themselves in where clear rules will clarify good conduct. And, of course, there are laws that must be complied with. However, while following the law can be an important ethical matter, using compliance as a proxy for ethics can impede developing a more ethical organizational culture.
Ethical Skills for Your Organization
This article describes some of the ethical skills Canmore Ethics focuses on when we work with organizations. Some of them are more appropriate for some roles than others, since building ethical capacity requires deliberation and tailoring to suit each situation. The vast majority of ethics education approaches are too blunt a tool to make meaningful progress. Instead, Canmore Ethics builds organization-specific strategies and resources that lead to more lasting improvements.
Four Steps to Patient-Centred Care: Moving Beyond the Buzzword
Patient-centred care is about providing care that aligns with the patient’s values: i.e., it’s care the patient actually wants and will benefit from. Despite the popularity of this concept, studies show that there’s a long way to go before it’s ubiquitous. In this post, we describe a four-step framework for implementing patient-centred care.
Why Your Hospital Needs Access to a Clinical Ethicist
There is overwhelming evidence that clinical ethicists provide tremendous value for patients, care teams, and hospitals. Where once clinical ethicists were only available at research and training hospitals, now, almost every hospital in the U.S. with more than 400 beds has one. This is because professional ethicists—especially those with advanced degrees in ethics and fellowship training—have consistently demonstrated the value of having access to experts in ethics advising.
Types of Clinical Ethics Consultations
Clinical ethics consultations can take many forms, and there’s no pathway they all must take. Instead, the ethicist, in consultation with the care team, will determine what level of involvement is most appropriate for the ethicist. In this article, I describe three levels of consultation and give some examples of each.
Pay People to Get Vaccinated
Applied to the vaccine, if governments do decide to pay people to get vaccinated, it seems unlikely that the amount offered will constitute undue influence. Of course, some people who weren’t going to get the vaccine (or were going to wait) will decide to get it sooner, but that’s the point.
Safe Supply as Treatment
A substantial number of deaths due to opioid use are unintentional and are at least partly due to the drug’s unknown strength and composition. In British Columbia, about 80 percent of drug-related deaths in 2020 have involved illicit fentanyl. Therefore, providing people who use drugs with safe supply would address a primary source of harm.
How Technology Causes Physician Burnout
The promise of clinical information systems (CIS), including electronic health records (EHRs) and other digital solutions, included fewer mistakes than hand-written notes, better continuity of care from access to patient records in different settings, and more efficient record keeping so that providers would have more time with patients. It hasn’t worked out this way.
Death by Neurological Criteria: Really, Most Sincerely Death
Brain death is just death. It is confusing and unhelpful to refer to someone as brain dead, and just as the term ‘heart dead’ isn’t capturing a useful distinction, neither is ‘brain dead’. As the authors in a Neurology article put it, following The Wizard of Oz, when someone is brain dead they are “really, most sincerely dead.”
Assisted Dying: Practical Considerations for Hospitals
Instituting a robust assisted dying regime requires addressing issues of different types. And, since the specifics of the legislation will affect how best to institute the policy, there isn’t a uniform approach all places can follow. Nevertheless, there are common issues that arise, and places can learn from those that have already gone through the transition. Here, we focus on some of the questions hospitals typically face when they decide to offer assisted dying.
Live Free or Guardianship: The Appropriate Standard
The Supreme Court of New Hampshire ruled that a guardian should disregard a patient’s stated wishes and make medical decisions according to the guardian’s view about the patient’s best interests. This goes against the consensus view in bioethics that wishes ought to be respected.
Two Models of Assisted Dying
A major theme of healthcare in the twenty-first century is the spread of assisted dying legislation. Each year, more US states and entire countries legalize assisted dying. This marks a dramatic shift, and it’s useful to explore the variations in approach. In this article, we summarize the two main models, based on Oregon and the Netherlands respectively.