For the past 13 years, Terri Schiavo of Clearwater, Fla., has
lived in a vegetative state with only a feeding tube to provide her
with nutrition and hydration.
While her parents believe she may one day recover from massive
brain damage incurred through heart failure, Shiavo’s husband
Michael has fought to let his wife die, which he said is in
accordance with her wishes.
The resulting feud has led to a nationwide debate over
euthanasia, involving Florida Gov. Jeb Bush and right-to-life
advocate groups.
Healthcare disputes, such as the case of Schiavo, create
problems for leaders in the medical field, who often find
themselves tangled up in catch-22 situations.
In an attempt to alleviate some of the ethical pressure
affecting the UCLA medical community, UCLA Healthcare has recently
created the UCLA Healthcare Ethics Center, located in the Westwood
Medical Plaza.
Started a little over a year ago, the Ethics Center has been
dedicated to enhancing the knowledge of medical personnel through
educational programs and by providing service and research to
doctors and patients engaged in bioethical issues.
The center is engaged in the debate over continuation of care,
which questions whether it is ethical to terminate care if, for
example, a patient could no longer pay medical fees or rely on
insurance.
The center’s main purpose is to bring together the three
different ethics committees of UCLA’s Westwood, Santa Monica
and Neuropsychiatric Medical Centers in an effort to improve the
networking of ideas among the hospitals.
“Issues arise that go across hospitals that necessitate
development of policies and interventions,” said Dr. Neil
Wenger, director of the Ethics Center and UCLA professor in the
Department of Medicine. “The center brings a coherence to
different committees that have never met before.”
The center uses input from the different research departments to
develop new policy and change existing treatment procedures.
“(The Ethics Center’s) goal is to improve ethics
education for doctors and physicians and to develop a regional
network with other hospitals to share this education,” said
Marge Cunningham, assistant director of the UCLA Medical
Center.
The center hopes to teach caregivers how to be better ethicists
within the hospital center.
The Ethics Center is headed by a core team of four medical
personnel, which includes Wenger and Cunningham, as well as
Katherine Brown-Saltzman, a clinical nurse specialist, and Les
Rothenberg, the Medical Center’s ethicist.
Members of the hospitals’ ethics committees and working
groups from the UCLA Medical Center’s Board of Advisors also
participate in the center’s research and education
programs.
Evaluating current policies for administering pain relief
medication and fighting against clinician burnout among nurses and
care givers are some of the other issues the Ethics Center group is
considering.
Educational seminars directed at raising awareness of ethical
issues are also offered by the center, and have been well attended
by doctors, nurses, residents, medical students and community
representatives.
These programs propel the Ethics Center’s mission to
promote clinical ethics education for the ethics committee,
clinicians and the community.
“We want to educate both physicians and patients in
possible treatment policies so that when conflicts come up between
a patient’s family and their doctor, discussion of the issue
can be improved,” Cunningham said.
As the center continues to grow, it will draw on perspectives of
health professionals and patients’ families to address the
challenging ethical issues of modern healthcare and to carry out
research to advance these ethical aspects.
“We’re hoping to bring in sociologists and ethicists
who will belong to the center and deal with the psychological,
legal and medical aspects of today’s treatments,”
Wenger said.
Funding for the UCLA Healthcare Ethics Center is provided by the
Partnership for Care and by gifts and donations from members of the
Medical Center’s Board of Advisers.
With reports from Daily Bruin Wire Services.