University Research Centre Partners with Local Charity to Deliver Workshop

The Centre for Bioethics and Emerging Technologies (CBET) at St Mary’s University, Twickenham recently partnered with local charity Princess Alice Hospice to deliver a workshop on the issues surrounding care for dying patients. Making Sense of Decisions at the End of Life was the theme of the Annual Ethics Study Day run by the Princess Alice Hospice in Esher, Surrey on Tuesday 13th January. The hospice delivers palliative and end of life care and support for patients and their families, and the workshop provided staff with the opportunity to openly discuss the difficulties they face in their roles. Director of CBET Prof Geoffrey Hunt, who is also the co-chair of the Hospice's Clinical Ethics group, opened the workshop with a presentation on Engaged Ethics which presented a conceptual tool for the analysis of interdisciplinary decision-making in a hospice setting. A wide range of professionals, including palliative care doctors and nurses, dieticians, speech therapists and physiotherapists, participated in the discussion of case studies led by Dr Craig Gannon, Deputy Director of the Hospice, and Prof Ann Gallagher of the University of Surrey. Prof Gallagher gave an overview of clinical ethics. In particular, she extolled the value of Virtue Ethics, describing a spectrum with the virtue lying between two vices (‘just right’ between too much / too little) which was then built on in the later sessions. Prof Hunt explained, "Such issues are ethical communication with families and across the team, improving the timeliness of decisions on admissions and interventions, consensual understanding in the team and the acknowledgement of the diversity of values often involved, compassion and approaches to denial, and avoiding a dogmatic or defensive procedural approach." He added that Princess Alice Hospice "leads the way in broaching such matters in honest and informed stakeholder dialogue." The day ended with a provocative presentation on the role, or lack of a role, for ‘sedation’ in palliative care, focusing on the common misunderstandings around the term and even the acceptability of sedation as an intervention (as opposed to ‘symptom control’). Dr Gannon said, “The Annual Ethics Study Day proved to be a hugely enjoyable and highly educational day for presenters and attendees alike. It was brilliant to then see the participants using Professor Hunt’s ethics tools, e.g. the need for ‘timeliness’, spontaneously and to great effect in the group work later in the day. “The whole event was highly evaluated, emphasising the importance of working together, linking hospice and academic colleagues to promote sound ethical decision making in our clinical practice. This relationship proved mutually beneficial; the hospice providing real examples from our day-to-day work to both challenge and test theoretical thinking and gain greater insight in return.”