Conscientious Refusal in Residency Training Jennifer Frank, MD, FAAFP Fox Valley FMR Program November 12, 2009.

Slides:

Advertisements

Similar presentations

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

Advertisements

Medical Law and Ethics The Physician-Patient Relationship By: Noha Alaggad.

IDC MANAGEMENT PROGRAM

Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Chapter 7 Ethics in.

Variations In Women’s Knowledge And Attitudes Regarding Preconception Healthcare Peter S. Bernstein, MD, MPH Professor of Clinical Obstetrics & Gynecology.

Caring for the “Compound” Patient: Ethical Challenges and Practical Advice for Obstetricians [Insert Name of Presenter] Ethics Resource Center American.

Adam Roise, MD, MPH Medical Director, Northeast Iowa Family Practice Center Assistant Program Director, Northeast Iowa Family Medicine Residency Program.

EPE C for VE T E R A N S EPE C for VE T E R A N S Education in Palliative and End-of-life Care for Veterans is a collaborative effort between the Department.

Attitudes towards euthanasia and physician- assisted suicide among physicians and patients in a multi-cultural society in Malaysia *ARM Fauzi, *MY Rathor,

Obtaining Informed Consent: 1. Elements Of Informed Consent 2. Essential Information For Prospective Participants 3. Obligation for investigators.

Legal Implications for Nursing. Legal Terms Negligence –A general term that refers to conduct that does not show due care –Occurs when someone fails to.

1 Teaching Cultural Competency: A Review of the Literature Sunita Mutha MD 1,2, Carol Allen MA 1, Cynthia Salinas MD 3, Arnab Mukherjea MPH 4 1 The Network.

Medical Ethics. Medical Ethics [vs. Professional ethics]  Ethical dilemma is a predicament in which there is no clear course to resolve the problem of.

10 Rights of Medication Administration

Patient Rights and Responsibilities Seton Medical Center Harker Heights.

The REAppropriate Study Perception of Inappropriateness of CPR Multicenter international cross-sectional survey.

ACGME OUTCOME PROJECT : THE PROGRAM COORDINATOR’S ROLE Jim Kerwin, MD University of Arizona.

Personal beliefs and medical practice Asad; Lale`; Rob;

Conscience in the Clinic: When Patient Requests and Physician Ethics Conflict Matthew A. Allison, MD, MPH Assistant Professor Family and Preventive Medicine.

Confidentiality in Adolescent Health Care: Research, Ethics, Law, and Policy Abigail English, JD Director Center for Adolescent Health & the Law Treuman.

What do patients and families need to know when errors occur? Susan Moffatt-Bruce MD, PhD, FACS, FRCS(C) Chief Quality and Patient Safety Officer Associate.

NORTH AMERICAN HEALTHCARE INFORMED CONSENT. RESIDENT RIGHTS Make decisions Accept or refuse treatment Be free from any physical/chemical restraints Receive.

Medical Law and Ethics Lesson 4: Medical Ethics

Patient Relations: Professionalism, informed consent, and abortion MS-3 Case Based Series Gretchen S. Stuart, MD, MPHTM Jennifer H. Tang, MD Amy G. Bryant,

+ Medical Ethics in O&G Dr. Anna Stienen-Durand ST3 O&G, RSCH

Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey All rights reserved.

A Teaching Hospital Challenge: Balancing Patient Care and Medical Student Education [Insert Name of Presenter] Ethics Resource Center American Medical.

LEGALITIES IN HEALTH CARE.  First adopted by the American Hospital Association in 1973  Revised in 1992 PATIENTS’ BILL OF RIGHTS.

Introduction Method Implications Educational training programs regarding self-injury have potential to improve professionals’ attitudes towards and comfort.

Attitudes and Perspectives on Ophthalmology Resident Training: The APORT Study Series Matthew J. Welch, M.D. and James F. McDonnell, M.D. Department of.

Patient’s Bill of Rights. The pt. has the right to considerate and respectful care. The pt. has the right to considerate and respectful care. The pt.

Assessment of Emergency Medicine Residents’ Bedside Communication Skills: A Survey of Emergency Department Patients Amanda Keller York College of PA Biology.

The Impact of a Simulation-Based Exercise on Knowledge Retention and Confidence Regarding Medication Use and Preparation for Medical Emergencies Marilyn.

Ethics in Advanced Prehospital Care. Topics to Discuss  What are Ethics?  Where do Ethics Come From?  Principles for Resolving Ethical Conflicts 

Legal and Ethical Issues Counseling Children. Child and Adolescent Clients Counselors who work with children and adolescents under the age of 18 may experience.

Ethics and Social Research

Disclosure of Financial Conflicts of Interest in Continuing Medical Education Michael D. Jibson, MD, PhD and Jennifer Seibert, MD University of Michigan.

Consumer Rights & Responsibilities in Health Care-Unit 3 Adonis K. Lomibao, R.N.

PATIENTS’ RIGHTS Dr. Suheab A. Maghrabi MBBS, MSc.

Module 4: Ethical/Legal Issues in Pediatric Palliative Care End-of-Life Nursing Education Consortium Pediatric Palliative Care C C E E N N L L E E C C.

Matsievskaya Larissa Leonardovna Karaganda 2014 Karaganda State Medical University Department foundations of psychology and communicative skills.

IRB Applications Ten Common Mistakes. 1. Failing to attach documents properly.

Medical Law and Ethics, Fourth Edition Bonnie F. Fremgen Copyright ©2012 by Pearson Education, Inc. Upper Saddle River, New Jersey All rights reserved.

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Legal and Ethical Issues.

1 [INSERT SPEAKER NAME DATE & LOCATION HERE] Ethics of Tuberculosis Prevention, Care and Control MODULE 5: INFORMATION COUNSELLING AND THE ROLE OF CONSENT.

Janet Lin, MD, MPH, Sweta Basnet, MS, Sara Baghikar, MD, Cammeo Mauntel-Medici, MPH, Sara Heinert, MPH University of Illinois at Chicago, College of Medicine,

Conscientious Objection MONICA BRANIGAN. Hastened death: multiple ways of participating Administer a lethal injection Provide a lethal prescription Attend.

Medical Ethics. Medical Ethics [vs. Professional ethics]  Principals to guide physicians in their relationships with others  Ethical dilemma is a predicament.

The process of answering: Strategic Planning 10.1 about your organization Who What How.

CONFIDENTIALITY. Three Confidentiality Laws 1.FERPA-Family Education Rights and Privacy Act (State Policy 4350: Procedures for the Collection, Maintenance.

Medical Law and Ethics, Third Edition Bonnie F. Fremgen The Physician–Patient and Physician-society relationship Chapter 5.

TEMPLATE AND PRINTING BY: GRMERC Consortium Members: Grand Valley State University, Michigan State University, Saint Mary’s.

Objectives Methods Introduction Results Conclusions To measure the self-reported competency of all EM residents with Level 1 milestones as they enter residency.

The Morning After Pill? Carly Sharp Janine Vance Ashley Walker Kalee Ankrum Wendy Cumberbatch.

IDENTIFICATION, DIAGNOSIS & REMEDIATION OF THE STRUGGLING LEARNER Jeannette Guerrasio, MD University of Colorado, SOM Chris Knight, MD University of Washington,

Awareness of the National Standards for Culturally and Linguistically Appropriate Services (CLAS) at an Academic Health Center Dr. Genny Carrillo Department.

Continuity Patient Panel Reassignment in Primary Care Residencies: A Report from the I 3 Collaborative Chuck Carter, MD, FAAFP Mark Robinson, MD Michele.

Research Profession and Practice ETHICS IN ADVANCED PREHOSPITAL CARE.

Bledsoe et al., Essentials of Paramedic Care: Division 1 © 2007 by Pearson Education, Inc. Upper Saddle River, NJ Division 1 Introduction to Advanced Prehospital.

Creating a Medical Maternity Home With Four Different Addresses Jennifer Frank, MD, FAAFP University of Wisconsin School of Medicine and Public Health.

Impact of Integrating Family Medicine and Pharmacy in an Interdisciplinary Anti-Coagulation Program B. Timothy Kodsi M.D., Michael Machek M.D., Keiran.

DOCTOR / DOCTOR AND DOCTOR PATIENT RELATIONSHIPS Idara C.E,

Presenter: Sarah Z. Cole, DO, FAAFP A Work in Progress (15 minutes)

How will residents’ personal values impact their future practice?

The Ethics of Being a Medical Student

Medical Professionalism

Jay Sicklick, Esq. Center for Children’s Advocacy August 6, 2018

CLICK TO GO BACK TO KIOSK MENU Material & Methods (Click)

ADOLESCENTS and IRBs Christopher V. Chambers, M.D.

Presentation transcript:

Conscientious Refusal in Residency Training Jennifer Frank, MD, FAAFP Fox Valley FMR Program November 12, 2009

Introduction What is known: Conscientious refusal (objection) is known to exist Prevalence (limited data) What is not known Behaviors surrounding conscientious refusal Appropriate professional, legal, and ethical standards

Examples of current legal and ethical issues in conscientious refusal include Pharmacy dispensing of emergency contraception Assisted reproductive technology in an unmarried/lesbian woman

A Survey of Conscientious Objection in US Physicians (Curlin et al, 2007) Focus on prevalence and characteristics of conscientious objectors C.O. to legal medical practices 17% object to terminal sedation 52% object to abortion for failed contraception 42% object to prescription of birth control to adolescents without parental consent

1. What is the prevalence of CO in family medicine residency programs? Do family medicine residents and faculty identify a personal moral opposition to any common, legal medical practices?

2. For those that identify a “conscientious objection” have they? Identified a way to care for patients requesting or requiring the procedure or prescription? Disclosed their objection(s) to their colleagues/supervisor? Disclosed their objection(s) to their patients?

Methods An 8 item web-based survey of residents and faculty in the UW Department of Family Medicine Participation was voluntary and anonymous 45% response rate (154 respondents) IRB exempt status

Results Questioned on 14 practices with a range of respondents with a reported objection The majority of respondents (87%) with an objection to a practice had not notified their medical director or program director of the objection. The majority of respondents (60%) had developed a plan to “inform, educate, and refer” patients who requested the procedure.

Moral Objection, self-report

Moral objection to performing/referring for an abortion

Other Moral Objections

Have you ever participated in medical care that you considered morally objectionable on the basis that the care was futile?

Have you ever refused to participate in medical care that you considered morally objectionable on the basis that the care was futile?

Respondent beliefs Physicians have an obligation to present all information to a patient (fully disclose) about a procedure (95%) Physicians have an obligation to refer (90%) It is acceptable for a physician to describe his or her objection (70%) A physician with a moral objection should disclose that objection to his or her practice partners (87%)

Conclusions Personal moral objections to legal medical procedures are common. While disclosure is viewed as an obligation, it is not necessarily practiced. While the majority of physicians with moral objections have a plan in place to care for patients, a significant minority have no plan developed.

Conclusions continued Physician beliefs around conscientious refusal indicate: Obligation to provide information Obligation to refer Acceptance of disclosure of reason why to patient Residents enjoy the same right to refuse as attending physicians

Implications and Future Directions Communication around moral objections Exclusion of physicians with moral objections? Ethics education and development

Ethics education Ethics instruction for medical students and residents should include: Discussion of the role of conscientious refusal Assistance with communicating moral objections to supervisors, colleagues, and patients Discussion of legal and ethical plans of care Discussion of moral objection around futile care

Questions?