Basic Standards Ethical Issues Bernard Heilicser D.O., M.S., F.A.C.E.P.

Basic Standards for Approval of Residency Training in Emergency Medicine Where is ETHICS?

Introduction …Shall provide meaningful objectives that prepare the resident to: 4. Make sound, ethical, and legal judgments as to the expected risks arising from therapy as well as the condition being treated.

Standards for Residents D. The resident is legally, morally, and ethically, responsible to pursue exclusively the agreed upon program of training.

Standards for Curriculum, Instruction, and Evaluation A. 6. The curriculum shall include instruction in medical ethics and interpersonal skills.

3 Times Informed Consent Process Job Restriction What Instruction? What Interpersonal Skills?

Core Curriculum Outline Form Administrative Aspects of Emergency Medicine –Departmental Administration –Hospital Administration

Broad Topics Ethical Principles Professional Relations Life-Sustaining Treatment Academic Ethics

Documents and Ethics AOA Code of Ethics 1998 Position Papers Bylaws of the COEP (March 2001)

Where Do We Begin? How do you teach a physician to be ethical? How do you standardize this? How do you exceed the minimum? What are the ethical standards we should hold ourselves to? –Professional –Societal

Standard 1 - Mission Purpose and Need Professional Responsibility Societal Responsibility

Standard 2 – Educational Program Goals and Objectives Achieve What? Enumerate Objectives –Institutional –Residents

Standard 3 – Institutional Requirement for Program Approval How to incorporate? Who is responsible? Oversight

Standard 4 – Faculty and Administration Who will teach? –Formal –Subjectively

Standard 5 - Residents Importance and legitimacy Consequences of failure –Professionally –Legally

Standard 6 – Curriculum and Instruction Core Curriculum is Framework –Amplify –Case Presentations Ethics Rounds All Case Presentations Journal Club

Casuistry Learn the rules and appreciate uniqueness Role modeling

Standard 7 – Facilities and Other Resources References Conflict resolution

Standard 8 - Evaluation Didactic testing Faculty review of case management

Conclusion Essential Better physicians and better patient care Virtuous people making right and good decisions