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Bioethics conference tackles tricky patient-physician communication issues


March 28, 2013

Ethical dilemmas surrounding clear and effective patient-centered communication are the focus of a one-day conference organized by the Arizona Bioethics Network and ASU’s Lincoln Center for Applied Ethics.

Open to the public, the April 12 meeting at Fiesta Resort Conference Center in Tempe qualifies for CME and CE for health care professionals who attend.

“Traditionally, discussions about ethics in health care have centered on static characteristics of the patient, such as autonomy and consent, without paying sufficient attention to how these characteristics and others appear in dynamic communicative relationships,” said Zachary Goldberg, Lincoln Fellow for Ethics Education and director of graduate programs for the Lincoln Center for Applied Ethics. “This conference looks at health care as a dynamic relationship with communication actually an essential part of providing ethical health care treatment.”

According to the American Medical Association, many people who read or hear standard health information do not fully understand it. A 2006 AMA report titled “Improving Communication – Improving Care” states that more than 95 million people in the United States have literacy levels below what they need to understand even basic written health information, such as how often to take a medicine.

When communication problems do exist, they often lead to difficulties in cooperation because health care professionals and their patients fail to understand each other, according to Gregory Loeben, associate professor and practicum coordinator for the public health program at A.T. Still University in Mesa. Mutual understanding is critical to building a strong consensus for moving forward, he said.

“When there are differences in cultural and spiritual beliefs, there’s often a breakdown in communication because either the doctor or the family doesn’t realize the full picture,” Loeben explained. “At the conference, we’ll use case studies to demonstrate how to slow down and improve communication in order to understand why people are acting and thinking as they are.

“It’s important to talk about the details of health care treatment in a way that connects with the beliefs of the family and patient so they can make choices consistent with the value system they hold. As health care practitioners, the last thing we want to do is impose decisions on patients and their families.”

A conference speaker, Loeben will lead a session on pediatric decision-making, an everyday occurrence in the health care field that adds another layer of ethical concern, he said.

“One of the big issues for clinicians is that they have two sets of patients – the adults doing the decision-making and the children themselves,” Loeben said. “As the child matures, the doctor needs to decide what role the youngster increasingly plays while balancing the parents’ desire to maintain authority.

“Ultimately, the physician needs to make a judgment that’s in the best interest of the child. If the parents say ‘this is what we care about’ and want to impose their decision on the child, and the doctor disagrees, then the question becomes at what point does the physician interfere?”

Other topics covered at the conference include the following:

• Breaking the Impasse: Understanding Spiritual Beliefs and Their Influence in Clinical and Bioethical Decision Making

• Respecting Autonomy or Protecting the Patient: Two Cases Involving Difficult Surrogate Decision Makers

• Building a Futility Policy: Communication as the Heart of the Solution

Attendees also will role play during interactive sessions designed to build their listening, observing and responding skills. During the first session, participants will practice staying “in the moment” by recognizing cues that they should quickly change their communication approach while avoiding the temptation to predict what others are going to say or do. In the second session, attendees will utilize the same exercises and group activity to focus on visual cues that can help them understand and communicate more clearly.

Those interested in attending “Effective Communication in Healthcare and Ethics” are asked to register at azbioethics.org. The registration fee is $80 per person, $25 per student.

ASU’s Lincoln Center for Applied Ethics, with support from St. Luke's Healthcare Initiatives, is revitalizing the Arizona Bioethics Network – a 400-member community of health care practitioners, professionals and students from related fields. This is the third annual conference of the Arizona Bioethics Network which is led by ASU’s Jason Scott Robert, Franca Oreffice Dean’s Distinguished Professor in the Life Sciences and interim director of the Lincoln Center for Applied Ethics.

The Lincoln Center for Applied Ethics, which is a research unit in the College of Liberal Arts and Sciences at Arizona State University, is a crucial catalyst for exploring moral responsibility in a world increasingly impacted at all levels – from human health to climate change – by human decisions. Its ASU cohort of internationally recognized scholars from diverse fields engages in cross-disciplinary applied ethics teaching and use-inspired research that advances ethical awareness and brings ethical considerations to bear on major issues.