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    Annual Summer Workshop in Clinical Ethics

    Summer Workshop X

    Decision Making for Unrepresented Patients
    and Developing Skills for Clinical Ethics Consultation

    Saturday, June 6, 2015
    8:30 - 4:15

    Occasionally patients come into health care with no identity. They are strangers who cannot speak for themselves, and thus their rights and their preferences cannot be protected. They may be ignored or exploited. This workshop will address the historical background to the problems of the unrepresented patient and explore the ethics of caring for such strangers. In the last few years, the Sutter Health West Bay Ethics Consultation Service has seen a large increase in consultation requests seeking assistance with treatment decision making for the unrepresented patient. Who is an unrepresented patient? How do you identify one?

    This workshop will describe and discuss how one can assess medical decision making capacity in patients. The morning session will include a case analysis of unrepresented patients and the steps to consider in dealing with these vulnerable patients. The afternoon will be a skills based workshop. How do you identify an ethics case and what are the key components used when analyzing an ethics case?

    The ethics care conference is an important element of an ethics consultation. Through role modeling, participants will be engaged in learning how to effectively organize, facilitate, and fully participate in a care conference. High quality patient care hinges on accurate documentation in the patient record, and a good ethics note is no exception. As the field of clinical ethics evolves, new standards for writing a clinical ethics chart note have emerged. Participants will get an opportunity to review samples of chart notes and review standards for writing a good ethics chart note.

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    Tuition: $125 – Physicians | $75 – Non-physicians
    Please pay with check or money order prior to June 1, 2015
    Payable to Program in Medicine & Human Values
    No refund will be made for cancellations on or after May 29.

    Additional $50 Nursing CEU fee for non-Sutter employed Nurses

    Registrant will receive a phone or e-mail confirmation upon receipt of payment.
    No refund will be made for cancellations on or after May 29.

    Mail to: Antonio Kruger
    Program in Medicine & Human Values
    California Pacific Medical Center
    2395 Sacramento Street, 3rd Floor
    San Francisco, CA 94115
    Fax to: 415.600.1355

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    Program Objectives

    1. Describe the steps needed to identify unrepresented patients and follow recommended processes for making appropriate treatment decisions.
    2. Demonstrate knowledge of tools and components necessary for assessing medical decision making capacity in patients.
    3. Demonstrate skills needed to conduct a care conference in ethically challenging cases when patients, families, and the medical team are involved.
    4. Outline key components of a well written ethics chart note as a part of the patient’s medical record.
    5. Explain the framework for ethical decision making, including the four quadrants used for gathering facts and analyzing an ethics case.
    6. Discuss the historical background regarding unrepresented patient issues and explore the ethics of caring for this vulnerable population of patients.


    • Albert R. Jonsen, Ph.D.
    • Jessica A. Evert, M.D.
    • Ruchika Mishra, Ph.D.
    • Ruaim Muaygil, M.D.
    • Alan W. Newman, M.D.
    • Shilpa Shashidhara, Ph.D.
    • William S. Andereck, M.D.

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    The Unrepresented Patient: The Ethics of Caring for OurMost Vulnerable Patients

    Albert R. Jonsen, PhD

    When the Patient Can’t Decide:
    How do we Assess Decision Making Capacity?

    Alan Newman, MD, Chair, Psychiatry, CPMC
    11:00-12:30Decision Making for the Unrepresented Patient
    • Challenging Patients: Learning Through Cases
    • Ethics Process Recommendations: Surrogate Designation, Hospital Policy, Legal Recourse
    • William S. Andereck, MD
    • Ruchika Mishra, PhD
    • Shilpa Shashidhara, PhD
    1:30-2:15What is an Ethics Case? Identifying Ethical Issues and Analyzing CasesRuchika Mishra, PhD
    2:15-3:05How to Conduct an Ethics Care Conference with the Medical Team and the FamilyJessica Evert, MD
    3:10-4:00The Do’s and Don’ts of Writing a Good Ethics Chart Note Ruaim Muaygil, MD
    4:00Summary and Conclusion-

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    Continuing Education Credits

    Target audience: Ethics Committee Members, Physicians, Nurses, Social Workers, Chaplains

    CEUs. California Pacific Medical Center (CPMC) is accredited by the Institute for Medical Quality/California Medical Association (IMQ/CMA) to provide continuing medical education for physicians. CPMC takes responsibility for the content, quality and scientific integrity of this live CME activity. CPMC designates this live educational activity for a maximum of 6 AMA PRA Category 1 Credits.
    this activity approved for 6.5 contact hours of BRN credit. Provider approved by the California Board of Registered Nursing, Provider #CEP 1956.Attendees must attend the course in its entirety.
    Social Work:
    CPMC provider #2245. Course meets the qualifications for 6.0 hours of continuing education credit for MFT's or LCSWs as required by the California Board of Behavioral Science.

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