Conversations About Ethics

Ethical Issues In Palliative Care: Skilled Conversations

Suffering is not a question which demands an answer, It is not a problem which demands a solution, It is a mystery which demands a “Presence”. ~Anonymous

The World Health Organization defines palliative care as an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems - physical, psychosocial and spiritual. 

Palliative care comes alongside families, as an invited guest, to walk with them through what can be a painfully difficult journey. It offers a support system that affirms life and regards dying as a normal process and helps individuals and families cope with the difficulties of living with chronic disease. 

How can professional healthcare providers and other caregivers have skilled conversations that are patient-centered and that address the physical, emotional and spiritual needs of the patient within the context of family and community? How can conversations be framed in a way that offer comfort, connection and healing? How can we help individuals and families live more fully and make informed, prudent decisions about where and how to live and die?

Learning Objectives

  • Name 3 key behaviors for successful conversations about care priorities. Successful conversations about palliative care are necessary for ethical outcomes, which balance patient autonomy with the just allocation of resources.
  • Identify 3 resources for further training in skilled communication. Skilled communication is imperative for clinicians, who must fully understand the context of a patient’s illness to permit ethical decision-making.

About our Speaker

DianeMeier_Photo2.jpgDiane E. Meier, M.D., FACP, is Director of the Center to Advance Palliative Care (CAPC), a national organization devoted to increasing the number and quality of palliative care programs in the United States. Under her leadership the number of palliative care programs in U.S. hospitals has more than tripled in the last 10 years. She is also Vice-Chair for Public Policy and Professor of Geriatrics and Palliative Medicine; Catherine Gaisman Professor of Medical Ethics; and was the founder and Director of the Hertzberg Palliative Care Institute from 1997-2011, all at the Icahn School of Medicine at Mount Sinai in New York City. Dr. Meier is the recipient of numerous awards, including the 2008 MacArthur Fellowship.. She was named one of 20 People Who Make Healthcare Better in the U.S. by HealthLeaders Media2010 and received an Honorary Doctorate of Science from Oberlin College in 2010. In 2012, she was awarded American Cancer Society’s Medal of Honor for Cancer Control in recognition of her pioneering leadership of the effort to bring non-hospice palliative care into mainstream medicine. Other honors include the Open Society Institute Faculty Scholar’s Award of the Project on Death in America, the Founders Award of the National Hospice and Palliative Care Organization 2007, AARP’s 50th Anniversary Social Impact Award 2008, Castle Connelly’s Physician of the Year Award 2009 and the American Academy of Hospice and Palliative Medicine Lifetime Achievement Award 2009. Dr. Meier served as one of Columbia University’s Health and Aging Policy Fellows in Washington, DC during the 2009-2010 academic year, working both on the Senate’s HELP Committee and the Department of Health and Human Services. Dr. Meier has published more than 200 original peer review papers, and several books. Her most recent book, Meeting the Needs of Older Adults with Serious Illness: Challenges and Opportunities in the Age of Health Care Reform, was published by Humana in 2014. She edited the first textbook on geriatric palliative care, as well as four editions of Geriatric Medicine.  Diane E. Meier received her BA from Oberlin College and her MD from Northwestern University Medical School. She completed her residency and fellowship training at Oregon Health Sciences University in Portland. She has been on the faculty of the Department of Geriatrics and Palliative Medicine and Department of Medicine at Mount Sinai since 1983. She lives in New York City.

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Resource List

This resource list brings together websites, videos, audio recordings, books, and articles to supplement the workshop and lecture.

By Our Speaker

Dipping Your Toe (Introductory Information)

Wading Waist High (Intermediate Resources)

Taking a Deep Dive (Advanced Materials)

Access to Materials

Freely available Online
Available through the San Antonio Public Library
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Available through the Briscoe Library at the UTHSCSA Faculty
Faculty, students, and staff may access these materials remotely using their Health Science Center log-in. Non-affiliated individuals and members of the general public may access these materials in-person by visiting the library and registering for guest access. Off-site access is not available for non-affiliated individuals and members of the general public due to licensing restrictions.