December 4, 2024 Webinar Information

“Shock me up to 5 times” – Can we override a patient’s CPR special directives?

Webinar Description

One of the most frequent reasons for ethics consultation in West Virginia hospitals, nursing homes, and hospices is a request for assistance with interpretation and implementation of advance directives or Portable Orders for Scope of Treatment (POST) forms. Often advance directives contain special directives such as the one in this case that request treatment that is determined to be outside the standard of care. A preventive ethics approach trains nurses, social workers, and others assisting persons in completion of advance directives to educate about what statements in special directives are prudent (and what are not)! This webinar will address 1) the medical context for this case and what CPR might provide that would not be provided by the defibrillator and whether it is likely to be of benefit, 2) what role those assisting persons to complete advance directives might play to avoid the writing of problematic special directives, 3) what the West Virginia Health Care Decisions Act states is the role of ethics committees in helping to resolve conflict when there is uncertainty about whether a person’s prior expressed wishes in a special directive apply to a current medical situation, and 4) whether providing CPR to a seriously ill octogenarian with a bad heart when her ICD does not restart it is within the accepted standard of care.

Panelists

The panelists for the webinar are Kim McFadden, MSW, Supportive Care Service, West Virginia University Hospital, Suzanne Messenger, Esq., State Long-term Care Ombudsman, WV Bureau of Senior Services,  Dan Miller, PhD, Assistant Professor in the Department of Philosophy, West Virginia University, and Alvin H. Moss, MD, Professor of Medicine, West Virginia University School of Medicine, and Executive Director of WVNEC. They will discuss the multiple clinical, ethical and legal issues in the case and recommend how best to advise the hospital social worker. Please attend, chat in your questions and comments, and learn answers to your questions and those of others.

Learning Objectives

At the conclusion of the session, participants should be able to:

• Describe the particular clinical and ethical issues raised regarding cardiopulmonary resuscitation in a patient who has a cardioverter-defibrillator (ICD);
• Cite West Virginia healthcare law relevant to cases involving ethical and legal conflict over application of special directives to patient care; and
• Apply an ethics process and relevant healthcare law to make recommendations to resolve cases involving conflict.