Monday, May 28, 2018 • 10:45 - 12:15
Track 3 - ED ETHICAL CHALLENGES
Track Chair: Dr. Merril Pauls
Room: TELUS 108-109

SMILE! YOU ARE ON CAMERA: Personal Mobile Device Recordings in the Emergency Department - Dr. David Migneault

Description: Over 70% of Canadians 18 years of age or older own a personal mobile device (PMD) (e.g. Blackberrys, iPhones, iPads, or Android phones). Both physicians and patients bring their PMDs to the ED and may record patient data, clinical encounters, or the clinical environment. This presentation will provide a review of the relevant legal and ethical issues to consider in the ED.

Learning Objectives:

  1. Enhance knowledge of privacy and confidentiality issues created by PMD recordings in the ED.
  2. Understand the risks and benefits of PMD recordings for both the emergency physician and the patient.
  3. Understand the ethical, medical, and legal requirements of PMD recordings in the ED.

Pearls:

  1. Emergency physicians need to obtain and document proper consent before using a personal mobile device to record patient data.
  2. Recordings on personal mobile devices improve patients’ understanding and adherence to their care plan.
  3. Institutional policies should aim at protecting the confidentiality of other patients in the clinical environment.

Biography: David Migneault is an emergency medicine specialist working at the Vancouver General Hospital and at the BC Children’s Hospital. He completed a Master of Science in Bioethics at Clarkson University at the Icahn School of Medicine at Mount Sinai in New York City. He has a special interest in privacy and confidentiality issues created by the use of new technologies in the emergency department.

Non-Cardiac Arrests: Interactions with Police and Correctional Services in the ED - Dr. Francis Bakewell

Description: This past year we’ve seen viral videos of nurses being arrested for refusing blood draws and read national news stories about police eavesdropping on patient histories in the ED. This presentation will use a series of cases to outline potential ethical issues in our interactions with police and correctional services in the ED, and how to overcome them.

Learning Objectives:

  1. Identify ethical issues that may arise with police officers, correctional services, and patients under arrest in the ED
  2. Understand the relevant federal and provincial legislation regarding patients who are under arrest, as well as professional and institutional policies
  3. Implement a simple, ethical, and professional approach to interactions with police and correctional service officers in the ED on their next shift

Pearls:

  1. Organizational policies and provincial laws vary regarding the presence of police in the ED – know what yours are!
  2. Assurances of confidentiality don’t just increase patient satisfaction – they improve patient care.
  3. Remember – you might be the last line of defence for your patient’s health information and privacy. Don’t be afraid to speak up!

Biography: Francis Bakewell is an emergency physician at the Ottawa Hospital, and has recently completed a MHSc. in Bioethics at the Joint Centre for Bioethics at the University of Toronto.

Unfit Drivers – Are We Doing Enough to Keep Our Roads Safe - Dr. Merril Pauls

Description: A man with a driver’s license and an uncontrolled seizure disorder visits multiple physicians, yet none report him to the provincial licensing authority. He subsequently has a seizure while driving and his car runs in to a school-house full of children. Who is responsible for this terrible outcome? Physicians may be legally liable if they fail to report an unfit driver and an accident occurs. And yet physicians often fail to make these reports, and the rules for reporting vary significantly from province to province. Can we make reporting of unfit drivers more rational, clear, and consistent across Canada?

Learning Objectives:

  1. List arguments for and against legislation that mandates physician reporting of unfit drivers
  2. Understand provincial variability in legislation and professional regulations in this area
  3. Identify problems with mandated reporting, and potential solutions

Pearls:

  1. A driver’s license is a privilege, not a right
  2. We have a responsibility to report unfit drivers based on the best evidence
  3. Consistent regulations and processes across Canada may improve reporting

Biography: Completed emergency medicine training in Winnipeg, Master’s in Bioethics at University of Toronto. Currently working at Health Sciences Centre in Winnipeg. Teach ethics at U of M medical school and chair of CAEP Bioethics Committee.