Sandhamn

Call for abstracts:

End of Life Decisions:
Ethics in clinical practice, research and policy


Clinical ethics is a multi-disciplinary and multi-professional field. We invite scholars and professionals to participate in a research symposium that focuses on end of life decisions such as shifting focus from curative to palliative treatment, how clinical research at the end of life can be improved and the role policy documents play in clinical practice.

In clinical practice, doctors and nurses must make difficult decisions regarding withdrawal of treatment, having regard to medical benefit, patient autonomy, and sometimes the role played by the patient’s family. Clinical research raises another set of questions. How do we distinguish between health care practice and research activities? How do we deal with information and consent in emergency situations or when the dying patient can be randomized only after losing consciousness? These questions are also challenges for policy makers that need to protect patients and research subjects, and at the same time facilitate research developments that improve health care practices that in turn provide better treatment and care for future patients.

This is the XI Annual Swedish Symposium on Biomedicine, Ethics and Society
and will be held on June 8-9, 2009 at Seglarhotellet, Sandhamn, an island in
the Stockholm archipelago.

>   Symposium website
http://www.crb.uu.se/symposia/2009/index.html
>   Call for abstracts
http://www.crb.uu.se/symposia/2009/call.html
>   General information
http://www.crb.uu.se/symposia/2009/information.html
>   Registration
http://eventus.trippus.se/end-of-life


Keynote speakers

Simon Woods, Policy, Ethics and Life Sciences Research Centre (PEALS), Newcastle University
Liisa Hovi, Hospital for Children and Adolescents, University of Helsinki
Sören Holm, Cardiff School of Law and University of Oslo
Nina Rehnqvist, SBU – The Swedish Council on Technology Assessment in Health Care


Call for abstracts

The first day of the symposium consists of keynote lectures and plenary discussions. The second day of the symposium consists of presentations in parallel sessions.

We now call for abstracts regarding end of life decisions in:

1.      Clinical practice
2.      Clinical research
3.      Clinical policy

Submission deadline: March 1, 2009

We invite scholars from all disciplines to investigate the moral dilemmas associated with these and other end of life decisions in clinical practice, research and policy. Abstracts should be submitted in .doc or .docx format,
250 words. Get abstract form:
http://www.crb.uu.se/symposia/2009/download/abstract-form.doc

Send your abstract to: crb (at) crb.uu.se;  josepine.fernow(at) crb.uu.se


Session I: End of life decisions in clinical practice

Clinicians face difficult questions when patients do not respond to
treatment. In this section we ask when it is appropriate to shift focus from
curative to palliative treatment and whether palliative treatments are
better than ordinary symptom control. When is it right to offer treatment
that has shown only anecdotal evidence? Experimental treatment may be seen
as offering a possibility of not giving in and may contribute to the
patient's quality of life, but it may also be regarded as something imposed
on patients and their families by doctors who are not prepared to give up.
Perhaps nurses and doctors perceive these decisions differently. Would a
doctor be more eager to find a diagnosis? Perhaps at the cost of a patient's
quality of life? What role should relatives play in these decisions and are
there economic factors that we should take into consideration?

Session II: End of life decisions in clinical research

Clinical research on patients at the end of life can be difficult and such
research is scanty, however, much needed. In this section we ask how
clinical research on dying patients can expand and improve, and on what
terms such research should be conducted. What informed consent procedures
are acceptable? Should we seek advance consent for research on those dying
patients that are unable to give consent? Experimental drugs can hasten
patients' deaths and increase their suffering. How do we find the balance
between costs and benefits in studies that may help future patients but have
very slim chances of benefiting subjects? A vast majority of patients for
whom conventional therapy fails will not be helped by research
participation. How do we ensure that patients desperate for a last chance of
recovery aren't subjected to the therapeutic misconception and how do we
make sure that they are not exploited when we enrol them in experimental
protocols?

Session III: End of life decisions in clinical policy

One way to meet the ethical challenges clinical practice raise is to develop
policy documents and clinical guidelines. An example of this is the national
guidelines for priority setting formulated by the Swedish National Board of
Health and Welfare, prescribing that priorities should be made out of
respect for human dignity, need, solidarity and cost efficiency. According
to these guidelines, palliative care is highly prioritized, as it would
otherwise constitute a breach of the principle of human dignity. Another
example concerns the guidelines for DNR (Do Not Resuscitate) that prescribe
when life-sustaining treatment may be withdrawn and what ethical concerns
such decisions raise. In this section we ask what role such policy documents
play in clinical practice. Are they of any practical help for clinicians in
their daily work? How are guidelines and policy documents developed and
implemented on the clinical level? And how are we to deal with the fact that
different guidelines and policy documents sometimes give contradictory
advice?


Planning committee

Stefan Eriksson <http://www.crb.uu.se/staff/stefan_eriksson.html> , ThD, Senior Researcher

Josepine Fernow <http://www.crb.uu.se/staff/josepine_fernow.html> ,
Co-ordinator

Mats G. Hansson <http://www.crb.uu.se/staff/mats_hansson.html> , Professor,  Director

Anna T. Höglund <http://www.crb.uu.se/staff/anna_hoglund.html> , Associate Professor, Senior Lecturer


Arranged by the Centre for Research Ethics & Bioethics in collaboration with:
Läkartidningen <http://www.lakartidningen.se/>  (the Journal of the Swedish
Medical Association)


Centre for Research Ethics & Bioethics
Uppsala Science Park
SE-751 85 Uppsala
Phone +46 18 611 22 96
Fax +46 18 50 64 04
E-mail:  crb (at) crb.uu.se
Web:   www.crb.uu.se