AHD Presentations and Faculty

American Health Decisions
“The Patient Alone: Making Health Care Choices for Patients Without Surrogates”

John Hancock Hotel & Conference Center
40 Trinity Place, Boston
May 6 – 7, 2008

To examine programs and protocols for making morally, medically and legally defensible health care decisions on behalf of people without surrogates, who are presently incapacitated, or in imminent jeopardy for incapacity.

Please note that many of the presentations below are linked to password-protected documents that can be opened only by persons who attended the conference. If you have thoughts about how American Health Decisions and this website could be useful to you and your organization in developing effective policies, structuring programs, or sharing information with colleagues nationwide, please let us know. Call David Clarke, director of Massachusetts Health Decisions at 781.784.1966 (eastcoast time). Or send email to: programs@masshealthdecisions.org

Tuesday, May 6, 2008

8:00 – 9:00 Registration / Continental Breakfast

9:00 – 9:15 Welcome / Introductions: David Clarke, DMin, JD, MPH

9:15 – 10:00 “Deciding for Others: An Ethical Framework” Dan W. Brock, PhD

10:00 – 11:00 “Deciding for Others: A Shifting Legal Landscape” Charles Sabatino, JD

11:00 – 11:15 Break

11:15 – 12:30 “Where Do We Stand? Existing Mechanisms and Challenges”
Erica Wood, JD; Naomi Karp, JD; Pamela Teaster, PhD

12:30 – 1:30 Lunch

1:30 – 3:30 Working Groups

1. State, Statutory & Regulatory Responses

The Public Guardian Systems: Pamela Teaster, PhD; Erica Wood, JD

New York State Surrogate Decision Making Committee Program:
Tom Fisher, MS, LNHA

2. Organizational / System Responses

“Health Care Decisions For Unrepresented Patients: Model Policy for
General Acute Care Hospitals”
Lori Cappello Dangberg

Ethics Consultation and Mediation Services: Ethics and the Law
Zita Lazzarini, JD, MPH

3. Interpersonal and Bedside Issues

When the Incapacitated Person Has a Disability
Gary Stein, JD, MSW

Dealing with Cases When Language and Culture Make a Difference
Jane E. Mendez, MD

3:30 – 3:45 Break

3:45 – 5:00 Decisionmaking for Persons without Surrogates: In Search of an Ethic Beyond Autonomy
Bruce Jennings, MA

5:00 PM End
Wednesday, May 7, 2008

7:45 – 8:30 Continental Breakfast

8:30 – 8:45 Welcome

8:45 – 10:30 “The Quest for Informed Decisionmaking from Patients and Surrogates”
Muriel Gillick, MD; Michele Karel, PhD; Jennifer Moye, PhD; Robert Orr, MD

10:30 – 10:45 Break

10:45 – 12:30 Working Groups

1. State, Statutory & Regulatory Responses

Court-Related Bioethics Consultation Panels
Naomi Karp, JD

Surrogate / Family Consent Statutes – Guess Who’s Coming to Decide for You?
Erica Wood, JD

2. Organizational / System Responses

Issues in Making Decisions for the Wards of Public Guardians
Pamela Teaster, PhD

How Ethics Committees and Consultation Services Can and Can’t Help:
A Clinician’s Perspective
Lachlan Forrow, MD

3. Interpersonal and Bedside Issues / The Role of Physicians

Muriel Gillick, MD; Robert D. Orr, MD

Representing Clients / Working with Guardians
Robert Fleischner, JD

12:30 – 1:30 Lunch

1:00 – 1:45 How to Fix the Broken System
Alice Herb, JD, LLM

1:45 – 2:30 Panel of Presenters, and What’s Next

2:30 PM End



Dan Brock, PhD
Director, Division of Medical Ethics, Department of Social Medicine, Harvard Medical School. Philosopher; author of Deciding for Others: The Ethics of Surrogate Decision Making

Lori Dangberg
Vice President for the Alliance of Catholic Health Care. The Alliance is the public policy and advocacy organization of California’s Catholic health systems and hospitals. She has been working in the public policy arena for Catholic health care for over 25 years and has worked extensively on end-of-life and bioethics issues.

Tom Fisher, MS, LNHA
Program Director, New York State Commission on Quality of Care & Advocacy for Persons with Disabilities, statewide Surrogate Decision-Making Committee Program

Robert D. Fleischner, J.D.
Assistant Director of the Center for Public Representation in Northampton, Massachusetts. He has written articles about advance directives and is co-author of Guardianship and Conservatorship in Massachusetts, published by Lexis.

Lachlan Forrow, MD Associate Professor of Medicine at Harvard Medical School and general internist at Beth Israel Deaconess Medical Center, Boston (BIDMC). He directs the Palliative Care Programs, the Ethics Support Service, and chairs the Ethics Advisory Committee at BIDMC. He is a member of the Institutional Review Board of the Harvard Cancer Center and President of The Albert Schweitzer Fellowship program.

Muriel R. Gillick, MD
Palliative Care and Geriatrics, Harvard Vanguard Medical Associates; Clinical Professor, Department of Ambulatory Care and Prevention, Harvard Medical School/Harvard Pilgrim Health Care

Alice Herb, JD, LLM
Asst Clinical Professor of Family Practice and Associate at Law, Division of Humanities in Medicine at State University of New York, Downstate Medical Center; Visiting Professor, Sarah Lawrence College, Masters program in Health Advocacy

Bruce Jennings, MA
Director, Center on Humans and Nature; Senior Consultant, The Hastings Center; Lecturer, Yale School of Public Health. Co-founder (with Mildred Z. Solomon) of Decisions Near the End of Life, a continuing education program that reached 40,000 health care professionals in 32 states during 1991-97.

Michele Karel, Ph.D.,
Staff Psychologist, VA Boston Healthcare System; Assistant Professor, Department of Psychiatry, Harvard Medical School

Naomi Karp, JD
Strategic Policy Advisor – Consumer and State Affairs Team, AARP Public Policy Institute; Co-Author, with Erica Wood, of “Incapacitated and Alone: Health Care Decision-Making for the Unbefriended Elderly” and “Guardianship Monitoring: A National Survey of Court Practices,” 2006.

Zita Lazzarini, JD, MPH
Director, Division of Medical Humanities, Health Law & Ethics, Univ. of Connecticut School of Medicine; Senior Faculty, The Center for Law and the Public’s Health at Georgetown and Johns Hopkins Universities. She chairs the UCHC John Dempsey Hospital Clinical Ethics Committee.

Jane E. Mendez, MD
Assistant Professor of Surgery at Boston University School of Medicine; Boston Medical Center, general surgeon, and breast surgeon for the Section of Surgical Oncology

Jennifer Moye, PhD
Director, Geriatric Mental Health, VA Boston HealthCare System, Brockton Division; Associate Professor of Psychology, Department of Psychiatry, Harvard Medical School

Robert D. Orr, MD
Professor in the Bioethics Program of the Union Graduate College and Mount Sinai School of Medicine; Former Director of Clinical Ethics and Professor of Family Medicine at Loma Linda University, Chair of the Council on Ethical Affairs for the California Medical Assn., and Vice President of the American Society for Bioethics and the Humanities.

Charles P. Sabatino, JD
Director, American Bar Association, Commission on Law and Aging

Gary Stein, MSW, JD Associate Professor, Yeshiva University, Wurzweiler School of Social Work; former Executive Director, New Jersey Health Decisions, and Project Director, The New York Academy of Medicine

Pamela B. Teaster, PhD
Associate Professor, Graduate Center for Gerontology, University of Kentucky, Principal Investigator and co-author of “Public Guardianship After 25 Years: In the Best Interest of Incapacitated People?”

Erica F. Wood, JD
Assistant Director, American Bar Assn., Commission on Law and Aging; Co-author, with Naomi Karp, of “Incapacitated and Alone: Health Care Decision-Making for the Unbefriended Elderly” and “Guardianship Monitoring: A National Survey of Court Practices,” 2006.

The Planning Committee believed that this conference would be useful to persons in positions to develop and implement policies, protocols and programs that address the primary problem of the gathering: Who will make decisions on behalf of people who cannot make their own choices and have no immediate surrogate? And how will those decisions be made? The Committee especially encouraged registrations from organizations that are committed to working in collaboration with others to effect solutions. Participants included senior staff, administrators, policy personnel, counsels and clinicians from non-profit service and advocacy organizations; health care institutions and systems; state legal and social services agencies; and professional legal, medical and service associations. We welcome your thoughts, suggestions, and recommendations for future activities to advance the issues of this conference. Please contact us at: programs@masshealthdecisions.org or call 781.784.1966.

This conference was offered by American Health Decisions, a non-profit, non-partisan association of state-based organizations that give the public a voice in shaping healthcare policy and practice through structured civic discussion, public and professional education, and collaborative programs with health care and community organizations. The conference was administered by Massachusetts Health Decisions. Both Massachusetts and American Health Decisions are 501(c)(3) tax exempt organizations. The conference was held in honor of our colleague, Mary Strong, the founder and director of the New Jersey Citizens Committee on Biomedical Ethics and co-founder, with Ralph Crawshaw, MD, of American Health Decisions in 1987.

For more information about the American Health Decisions organizations, CLICK HERE.