Tuesday June 15
Track Chairs
David Migneault
MD FRCPC
Merril Pauls
MD CCFP(EM)
David Migneault is an emergency medicine specialist at the Vancouver General Hospital, the BC Children’s Hospital, and the UBC Urgent Care Centre. 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 is an ethicist for Vancouver Coastal Health, a member of the CAEP Bioethics Practice Committee, and a member of the CAEP Standing Committee on Finance and Audit (COFA).
Merril Pauls trained in emergency medicine in Winnipeg, received a degree in bioethics from the University of Toronto, and worked in Halifax for 5 years before returning to Winnipeg. He is currently a Professor in the Department of Emergency Medicine, and co-lead for Professionalism teaching in the College of Medicine.
Description
Part 1 – interviews with emergency physician-ethicists across the country (and from the USA) will get their perspectives on the toughest ethical challenges faced by emergency physicians during the COVID 19 pandemic. We will also focus on potential solutions and coping strategies.
Part 2 – an expert panel will discuss one of the more challenging situations emergency physicians face – the high-risk opiate overdose who wishes to leave against medical advice. We will discuss capacity assessment in these cases, and explore the role of legislation that would allow physicians to hold these patients involuntarily (particularly minors).
Learning Objectives
Discuss the most challenging ethical issues emergency providers have faced during the COVID 19 pandemic and identify potential solutions and ways of coping.
Describe a rational approach to capacity assessment in patients who wish to leave hospital after treatment for high-risk opiate overdose.
Identify the potential benefits and harms of secure care legislation – with a specific focus on the minor patient.
Speakers
Critical Care Triage During COVID-19: Ethical Issues Affecting Emergency Clinicians
This presentation will highlight some of the ethical issues that emergency clinicians will face if a critical care triage system is implemented in the context of COVID-19.
Off Guard: The Ethics of Being Unprepared
A discussion of the most significant ethical issue of the pandemic: a lack of preparedness in our medical system, and a lack of capacity to respond to throughout the pandemic.
Learning Objectives
Appreciate that the most significant ethical error of the pandemic took place before it even started: a lack of preparedness within our medical system.
Discuss the ethical duties of a medical system to be prepared, duties best exemplified in the practice of emergency medicine.
Brainstorm how emergency medicine might better champion preparedness throughout our medical system going forward.
Pearls
Preparedness is a relatively unexamined virtue, but one that emergency providers are particularly well-equipped with.
Being prepared is the best way to meet all of our other ethical duties in medicine, regardless of outcome; by contrast, being unprepared means we must share in the ethical responsibility for bad outcomes.
As experts in preparedness, emergency providers have a particular duty going forward to advocate for a prepared, responsive, and capable medical system that can withstand the devastation of pandemics.
On the Front line of a Pandemic
Ethical principles that have accompanied my team in decision-making for ER management to ride the COVID waves
Learning Objectives
Understand the ethical principles that guided decisions in managing the COVID crisis in ER
Demonstrate the key role of emergency department teams in the management of a pandemic or any other sanitary crisis
Learn collectively and from an individual perspective of the current crisis for benevolent risk management
Pearls
Be on the front lines to protect your teammates at the same time to protect patients
Communicate all the time, even if you don’t know the answer
Be present, constant and open-minded throughout the race
COVID-19 in a New York City ED – Goals of Care & Resource Management
Panel Discussion: High Risk Addictions, Capacity Assessment and Forced Treatment
An expert panel will discuss one of the more challenging situations emergency physicians face – the high-risk opiate overdose who wishes to leave against medical advice. We will discuss capacity assessment in these cases, and explore the role of legislation that would allow physicians to hold these patients involuntarily. (particularly minors)
Learning Objectives
Describe a rational approach to capacity assessment in patients who wish to leave hospital after treatment for high-risk opiate overdose
Identify the potential benefits and harms of secure care legislation – with a specific focus on the minor patient
Panel Members
