Ethics Committees

UMHC/Sylvester Comprehensive Cancer Center Ethics Committee is co-chaired by Dr. Don Temple (Hematology/Oncology) and Dr. Kenneth Goodman (Ethics Programs). It meets bimonthly as well as “as needed” to address ethics issues in policy and patient care.  [Link to Ethics Committee Brochure] Members include UM Ethics faculty as well as clinicians and staff from Sylvester and outpatient clinics, and the Courtellis Center for Psychosocial Oncology

For an ethics consult at UMHC/Sylvester CCC, UMH – Contact the UM call center at 305-243-2222 and request that “Ethics Consult” be paged. 

Ethical Guidance

Informed Consent for Chemotherapy: ASCO Member Resources. J Oncol Pract. 2008 November; 4(6): 289–295. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2793915/

American Society of Clinical Oncology Statement: Toward Individualized Care for Patients With Advanced Cancer (2011) http://jco.ascopubs.org/content/early/2011/01/24/JCO.2010.33.1744.full.pdf+html

American Society of Clinical Oncology Provisional Clinical Opinion: The Integration of Palliative Care into Standard Oncology Care.  J Clin Oncol. 2012. May 10, 2012:1715-1724. PMID: 22312101

American Society of Reproductive Medicine. Fertility Preservation and Reproduction in Cancer Patients. 2005. http://www.sart.org/uploadedFiles/ASRM_Content/News_and_Publications/Ethics_Committee_Reports_and_Statements/FertilityPreservation.pdf

Articles

Why do patients choose chemotherapy near the end of life? A review of the perspective of those facing death from cancer.  J Clin Oncol. 2006 Jul 20;24(21):3490-6. http://jco.ascopubs.org/content/24/21/3490.long PMID: 16849766

The role of chemotherapy at end of life.  JAMA. 2008;299:2667-2678. PMID: 18544726

Medical care and emotional distress associated with advanced cancer patients’ end-of-life discussions with their physicians.  J Clin Oncol. 26:2008. http://www.asco.org/ascov2/Meetings/Abstracts?vmview=abst_detail_view&abstractID=31485&confID=55

Beyond Advance Directives: Importance of Communication Skills at the End of Life
JAMA. 2005;294(3):359-365. PMID: 16030281

Associations Between End-of-Life Discussions, Patient Mental Health, Medical Care Near Death, and Caregiver Bereavement Adjustment. JAMA. 2008;300(14):1665-1673.PMID: 18840840

Religious Coping and Use of Intensive Life-Prolonging Care Near Death in Patients with Advanced Cancer.  JAMA. 2009. Mar 28; 301(11):1140-7. PMID: 19293414

Cancer Experts Recommend Introducing Palliative Care at Time of Diagnosis. JAMA. 2012;307(12):1241-1242. PMID: 22453558

Early Palliative Care for Patients with Metastatic Non-Small Cell Lung Cancer. NEJM. 7422010; 363(8):733-42. PMID: 20818875

Ethical and Value Issues in Insurance Coverage for Cancer Treatment. The Oncologist. 2010;15(suppl 1):36-42. PMID: 20237216

Effect of Telecare Management on Pain and Depression in Patients with Cancer: A Randomized Trial. JAMA 2010;304(2):163-171. PMID: 20628129

Policy

2011 - Florida “Position Statement for Florida Hospices and Palliative Care: Advance Health Directives and POLST (Physician Orders for Life Sustaining Treatment)  http://med.fsu.edu/userFiles/file/FHPC%20Position%20Statement%20on%20POLST.pdf

2011 - New York “Palliative Care Information Act”
New York State passed a law requiring physicians and nurse practitioners to talk to patients with an expected survival of less than 6 months about their options, including hospice care and aggressive vs. palliative treatment, although patients can refuse to discuss end-of-life care if they choose. http://www.health.ny.gov/professionals/patients/patient_rights/palliative_care/information_act.htm

2008 - California “Right to Know End-of-Life Options Act” 
California requires an attending health care provider who determines that a patient has a terminal illness to provide the patient an opportunity to receive information and counseling regarding all legal end-of-life care options, including palliative care, hospice care, refusal or withdrawing of life-prolonging treatments, voluntary stopping eating and drinking (VSED), and palliative sedation, if the patient requests the information. http://www.leginfo.ca.gov/pub/07-08/bill/asm/ab_2701-2750/ab_2747_bill_20080930_chaptered.pdf