May 01, 2010 — Miami Beach, FL —
Imagine an influenza pandemic sweeps across Florida, and hospitals are swamped with too many patients in desperate need of too few ventilators. How will they decide who gets one?
More than 300 doctors, nurses, social workers, lawyers, clergy and others from across the state grappled with that and other weighty questions at the 18th annual University of Miami/Florida Bioethics Network Spring Conference, “Florida Ethics: Debates, Decisions, Solutions.”
“If there’s an emergency and people start showing up by the thousands at hospitals it will be an extraordinary challenge,’’ said Kenneth W. Goodman, Ph.D., professor of medicine and philosophy, founder and director of the University of Miami Bioethics Program and director of the Florida Bioethics Network. “Emergency preparation and response raise thorny challenges for both ethics and science.”
A highlight of the conference, held at the Miami Beach Resort and Spa on April 9, were presentations on the role of human rights in medical education by the deans of Miami-Dade’s two medical schools: Pascal J. Goldschmidt, M.D., senior vice president for medical affairs and dean at the Miller School, and John A. Rock, M.D., senior vice president for medical affairs and founding dean of the Herbert Wertheim College of Medicine at Florida International University. Both institutions are devoted to serving the community and reducing health disparities and the social determinants of disease in South Florida and beyond.
“Human rights are the basis for ethics,” Dean Goldschmidt said, invoking the late Rev. Dr. Martin Luther King Jr.‘s powerful observation. ‘“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.’ So…it is particularly important in professional education to insist on the importance of ethics.”
Dean Rock said medical schools are obligated to ensure their students retain their enthusiasm for medicine and commitment to “social reform, social good and the social mission.”
“We’ve done a good job in some institutions of drumming out that kind of commitment over the four years of professional education,’’ he said. “We need to put it back in. We need to nurture it. We need to make our medical students culturally competent so that they understand the diversity of our country and the needs of our population.’‘
The largest community bioethics conference in the country, the meeting also featured a sobering discussion of proposed state guidelines for allocating finite resources, such as ventilators, during a pandemic or other disaster. Members of Florida’s Public Health Ethics Workgroup, a panel of ethicists from around the state who are working on the guidelines for the Florida Department of Health, described how they reached their recommendations. They also emphasized the importance of engaging the public when developing policies for rationing care and the other difficult decisions caregivers will inevitably face.
“In catastrophic medicine, in mass casualty medicine, there is going to be a different order,’’ said Robin Fiore, Ph.D., associate professor of philosophy at Florida Atlantic University and a member of the Florida Bioethics Network Advisory Board. “So the beliefs you have today might not in fact hold. What ethics can do is point out to you what needs to be thought about to come to a commitment to be able to do what you are asked to do.’‘
Both Goodman and Fiore serve on the ethics workgroup, along with university faculty and public health officials from around Florida.
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