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Ethics Event Ideas

Capacity building activities are an important aspect of health care ethics. It can be difficult, though, to come up with new, exciting and innovative ideas for talking about ethics in your area. While the standbys like presentations and journal clubs will always attract a few interested ethics die-hards, it can be a challenge to create activities and opportunities that will appeal to those who might not come out regularly.

Ethics event or education ideas don't need to be complex or elaborate. Simple, short activities like a case study or a movie clip can be effective in helping staff to put an ethics lens on the work they do. Over the years there have been countless ethics events in Manitoba, randing from small gatherings on a ward or work unit to large-scale conferences and invited guest speakers. We have collected the ideas from Health Ethics Week Events, and collated them here to provide ideas and inspiration for anyone planning an event.

Please consider sending us ideas, descriptions and photos of your events for inclusion on the list. In addition to building ethics capacity in your own area, you may also inspire others as well.


 

Discussion Topics

  • Palliative Care Conundrums...The Role of Ethics in your Work.
  • What About Trust?
  • Keep Them Awake at Night.
  • Why is the trend to move people out of places like St. Amant (and government) and is seeking to open more "institutions" for the elderly?
  • Generate questions (local funding, federal funding, provincial funding). How can these questions be asked? How does "the public" pose their questions?
  • Health Dollars. Equity - e.g. Palliative Care is poorly funded universally - many dollars and/or time for breast reconstruction - is this public funded or privately funded?
  • How do we decide how much to weigh the desires/concerns of a patient's family vs. what the patient wants or what we think is best for the patient and/or system?
  • The Ethics of Managing Long Term Child Health.
  • Extending life versus prolonging the dying process.
  • Managing the "I am going to sue" or "I am going to call the press" threats.
  • No shows for dialysis.
  • Beds, machines and treatments are wasted.
  • Advanced dementia: "offering" or "forcing" nutrition.
  • "Right to risk" vs. duty to care and keep safe.
  • Ethics from a jurisdictional standpoint when working between regions (repatriation, transportation, follow through).
  • Discuss those situations where we are dealing with adults who are competent. They are allowed to make their own decisions, even if we do not agree with them. Especially those people who do not 'fit' into the box - dow do we reduce harm for them, ensure they have access to the services that they need, etc.
  • Physician assisted suicide.
  • Long term care - "A Place to Live or Die".
  • Ethics and Financial Abuse.
  • Building a better tomorrow.
  • "Spirituality in Healthcare: Dialogue, Decisions and Duties" DVD by Daniel Sulmasy.
  • Theme of uncertainty.
  • Navigating moral uncertainty.
  • How Certain Are You About 'Moral Uncertainty"?
  • Compassionate Lies.
  • The Ethics of Deception.
  • Ethical implications in addressing advance care planning discussions.
  • Treatment-Resistant Major Depression and the Capacity to Terminate Care.
  • Ethical Issues in Substance Abuse Prevention and Treatment. Caring for the "difficult" client.
  • Talking about Ethics in the Personal Care Home.
  • The Ethics of Customer Service in Long Term Care.
  • Golubchuk case.
  • Doing the Right Thing - Doing the Thing Right.
  • Ethics in a Box Resource Kit.
  • Articles from the Ethics...for Everyone columns.
  • The Role of Ethics Consultation on Inpatient Care and the Hospital's Moral Milieu.
  • Ethics and Life Values Ethical Issues in Dementia Care Risk and Reward in Ethics Consultation or When is Nothing Better Than Something?
  • Am I making the Right Decision? The Challenges of Substitute Decision-Making.
  • How do we know when treatment is becoming burdensome?
  • Truth telling.
  • Language barriers.
  • Ethics in Nursing Practice - when some staff are not competent, there is a long way to go prior to suspending them from practicing. Co-workers avoid conflicts, Unions protect their members. Meanwhile, patients/clients don't get optimal service.
  • Ethical issues in involving families during patient resuscitation.
  • Overmedication and use of over-the-counter medications for patients who are living in Long Term Care.
  • Why it is ethically wrong to work in the health care field and not get an influenza immunization.
  • Ethical considerations when working with people who have dementia and their families. Issues of competency and decision-making.
  • Older adults with mental health and addictions.
  • How to make medical treatment decisions at end of life for patients who are incapacitated due to paranoid schizophrenia or other mental health impairing decision making capacity; when patient is competent and aware and does not want treatment that will assist with mental health.
  • Engaging of children - children's perspective.
  • Normalizing moral distress; helping care providers understand that it is okay to sometimes not be okay with what's happening in a particular situation. Helping staff identify, name, and explore moral distress as an opportunity to engage in discussion, perhaps some paradoxical analysis to achieve a better understanding of opposing viewpoints.

General Event Ideas

  • Lunch & Learn Event - "What are Ethics and How do they Effect the Work we Do?"
  • "The Thing with Feathers" - a play by Katherine Koller.
  • Presentation and discussion of a case scenario at a team meeting using the Framework for Ethical Decision-Making.
  • "Spirituality & Ethics in Healthcare: A Panel Discussion Exploring the Connections between Spirituality and Ethics".
  • "Should Former Patients Visit???" - Dr. Marie Edwards.
  • Ethics for Lunch Session - "Your brother's not a candidate for this procedure".
  • Visual display outside the Cafeteria.
  • Poster presentation.
  • Lunch & Learn Event - "What's Ethics Got to Do with Me?"
  • A table and poster board display in a main foyer complete with ethics framework, terms of reference for Ethics Committee and other ethics related information.
  • Ethis Jeopardy Game.
  • Ethics video and discussion on "Misgivings" by Barbara Farlow.
  • Ethics video and discussion on "End of Life in the ICU" by Joel Zivot.
  • Showing and discussing video clips/stories, complete with popcorn.
  • Poster display in the cafeteria along with Ethics Committee members available to speak to staff regarding the committee along with an Ethics box where people can place a comment, scenario or thoughts on the committee.
  • A PowerPoint Presentation set up in the library on ethical principles and concepts.
  • Create and distribute posters to all staff with some definitions encouraging staff to think of the topic of Hope and Healing and how staff impact patient care.
  • "Time for Tea with Food for Thought" where movie clips can be shown around ethics.
  • Popcorn and movie night showing "My Sister's Keeper".
  • Hold discussions around episodes of the sitcom "House".
  • Posters and tent cards with case scenarios placed in conference rooms and cafeterias.
  • Review Toolkits for Ethics Committees.
  • Distribution of your Framework for Ethical Decision-Making.
  • A walk for ethics.
  • A crossword puzzle focusing on ethics.
  • Ethics for Lunch Session on "Uncertainty".
  • Distribute a questionnaire to staff around "Grey's Anatomy" sitcom.
  • Ethics Trivia Game.
  • Send out articles to staff on ethics.
  • Send out a listing of places people could access ethics training if they were interested.
  • Include information on Internet and Intranet sites about ethics with links to various websites.
  • "You're Talking Ethics" and Moral Distress posters and tent cards found here.
  • "Bite of the Spider" by Katherine Koller.
  • Health Ethics Week posters and banners added to website.
  • Take a look at the ethical dilemmas hidden in fairy tales like Jack & the Beanstalk (was Jack right to trespass and steal from the giant?) or Little Red Riding Hood (was it in Red's best interest to be sent out, alone, in the woods, with a basket of food, for her grandmother?
  • To whom else should the duty of care for the grandmother be assigned?).
  • Myths and Facts information to be distributed electronically and/or included in a staff newsletter.
  • "Handbook for Rural Health Care Ethics: A Practical Guide for Professionals" to be reviewed by inpatient and outpatient service providers.
  • Staff, patients and guests who get spotted in discussion about ethics win a gift card.
  • Connect to the Ethics Grand Rounds hosted by St. Boniface Health Ethics Service, either in person or via MBTelehealth.
  • Send staff an email regarding "Ethics in YouTube" where staff are asked to view a specific video and answer corresponding ethical questions.
  • Create a contest for staff including multiple sample ethical situations.
  • Invite staff to write in discussing their views on the situation and explaining how they would resolve the issue.
  • Post an article in a local newspaper including a case scenario with an invitation to the public to respond with the option they would choose.
  • "Check your Ethical Vital Signs" activity.
  • Library display that features books and resource materials on ethics in long term care, mental health, palliative care, nursing and other related topics.
  • "An Ethical Lens on Long Term Care" DVD.
  • The game of "Scruples".
  • Leadership attendance to an Ethics Awareness Meeting.
  • Post some ethics questions in a common area of the workplace for a couple weeks.
  • Once complete, compile responses and post the varying opinions.
  • Ethical self-awareness exercise.
  • Role play an ethical dilemma.
  • Allow participants to discuss and express their views after the role play is complete.
  • Make ethics cases available in a staff lounge with questions, a word search and an ethics definition matching game.
  • Ethics Education Day.
  • "Spot the Dilemma" Blog - have people identify and talk about ethical issues they have noted in the news (should be something most people would have access to - not work related).
  • Have a "Problem Solver Forum" where an ethical problem is posted (monthly/weekly, etc.) and participants can submit their "solution" with their rationales for their position (grounded in ethical frameworks).
  • Have a place where staff can write down the ethical questions they face on a daily basis.
  • Use these questions as a discussion starter when staff gather together.
  • During annual required education sessions for staff, include an ethics discussion on a scenario similar to something they would encounter.
  • Hold a workshop for staff and the public on a topic in ethics and invite a guest speaker.
  • Draw up a quiz about ethics during Health Ethics Week and have staff fill out and place in a draw box for a prize.
  • Laminate the region's framework for ethical decision-making and have them posted at nurses' stations at each site.
  • Have the Ethics Committee approach the professional leads in the building - respiratory, pharmacy, maintenance, environmental cleaning, speech and language pathology, social work, physio, OT, home care, health care aides, etc. asking them to submit a short written case study that affects their staff. This could be published monthly in the site or region's newsletter.
  • Include residents and family members on your ethics team.
  • Have "ethics huddles" where an ethics committee member might meet with staff to discuss an ethical dilemma.
  • Ethics talk blurbs shared at monthly staff meetings.
  • Monthly "Ethics at Break" having fun with ethics over coffee and donuts.
  • Debriefings of staff when an issue could potentially cause moral distress.

Case Studies

  • A resident coughs continuously when eating regular textured food. A swallowing assessment was completed and placed on a ground and then pureed diet to prevent aspiration and further medical problems. After a meeting where family and resident requested regular texture food to make meals more appealing in hopes that the resident would eat more. The daughter of the resident stated that she would rather choke to death eating food that looked like food rather than starve to death.
  • Placing clients into long term care can be a very difficult task. A large portion of this clientele have a diagnosis of dementia or have engaged in lifestyle choices that have rendered them with diminshed capacity (physical and/or emotional). Common practice is to allow folks who have (to date) demonstrated to be an appropriate designated advocate - to make disposition decisions for cognitively impaired clients. The clients themselves however routinely do not wish to be placed in long term care. Ethically - do we need to officially strip clients of their rights and have them deemed incompetent to ensure a safe living arrangement or do we continue to run on the assumption that the designated advocates have the client's best intesrests at heart?
  • Placing an individual who has a criminal history into a long term care facility amongst a vulnerable population. How do we continue to serve those with dementia because time and time again, such clients in hospital meet long term care criteria, however further to care, scheduled medications and nutrition, such clients convalesce and regain various levels of independence - including competency. Situations arise where clients are placed in to long term care due to cognitive decline and functional limitations - who regain strength and cognitive functioning - who then begin to engage with the "outside world" again, and the cycle of alcohol/drug misuse begins again.