OHSU, Legacy Host Two-Day Conference to Address Access to Health Care, Death and Dying Issues

04/04/03    Portland, Ore.

Former Oregon Gov. John Kitzhaber, M.D., to address health care access crisis

Health care professionals from across the Northwest will converge on Oregon April 10-11 to discuss two key ethical dilemmas routinely faced by patients and their physicians -- access to health care and care for the dying. To help physicians and other health care professionals better understand and respond to these issues, the Oregon Health & Science University (OHSU) Center for Ethics in Health Care and Legacy Health System are co-sponsoring the annual Kinsman Conference. This year's theme is "Facing Our Ethical Challenges: Access, Quality, End-of-Life Care." The series of lectures and workshops will feature 29 presentations - including programs by nationally respected gerontologist and OHSU School of Medicine Dean Christine Cassel, M.D.; and Diane Meier, M.D., director of the Hertzberg Palliative Care Institute at the Mt. Sinai School of Medicine.

"The Annual Kinsman Conference affords health care professionals across the region the opportunity to not only enhance their knowledge around critical ethical issues, but also to network with one another as they search for mutual solutions to address these challenges," said Maggie Allee, R.N., J.D., director of the Legacy Heart Institute, Legacy Transplant Services, and chairwoman of the Kinsman Conference.

ACCESS TO HEALTH CARE
Speakers and workshops on the first day of the conference (Thursday, April 10) will focus on a major challenge for Oregon at this point in time - access to health care.

"Our state is at a critical crossroads when it comes to patient health care access," explained Susan Tolle, M.D., director of the Center for Ethics in Health Care at OHSU and co-chairwoman of the conference. "Patient lives may literally lie in the balance as lawmakers search for ways to ensure that low-income residents continue to get the care they need as the state faces multimillion-dollar budget shortfalls caused by the withering economy."

Former Oregon Gov. John Kitzhaber, M.D., will deliver opening remarks. Specialized topics include: access to mental health care, health disparities, screening patients, ethical issues behind developing the drug formulary, women and access to care, and allocation of scarce resources. In addition to these topics, health professionals will also have the opportunity to hear the latest recommendations for care providers working with patients who wish to supplement or replace their treatment with complementary and alternative medicine (CAM).

"It is imperative that physicians consider the ethical obligations when tolerating or recommending for or against CAM therapies," said Karen Adams, M.D., assistant professor of obstetrics and gynecology in the OHSU School of Medicine, and a presenter at the conference. "CAM should not be dismissed out of hand or accepted blindly."

END-OF-LIFE ISSUES
Day two (Friday, April 11) of the conference will concentrate on end-of-life issues. Some of the key topics include: respecting patients' values in end-of-life care, building palliative care programs, medical mistakes disclosure at end-of-life, financial barriers to end-of-life care and music thanatology.

"Oregonians hold hospitals and doctors to the highest standards of pain and symptom control at the end of life," said Jocelyn White, M.D., medical director of Legacy Clinical Ethics and the Legacy Comfort Care program. "Quality data show that palliative care teams are the best at relieving pain and suffering in hospitals. We have an ethical imperative to provide this expert resource throughout the region."

Also on day two of the conference, Linda Ganzini, M.D., director of the Palliative Care Fellowship at the Portland Veterans Affairs Medical Center, and professor of psychiatry and medicine in the OHSU School of Medicine, will discuss the implications of Oregon's unique Death with Dignity Act on palliative care.

"For some patients, effective palliative care may very well be an acceptable alternative to physician-assisted suicide," explained Ganzini. "It's always important for physicians to ensure that patients have adequate decision-making capacity, don't feel that their choices are limited and don't act impulsively."

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