Objectives

1. Describe ways that local or institutional-specific ethics policies have broader community implications.

2. Explain why it is important for HEC members to educate the broader (not just institution-speciic) community about ethical policies.

3. Propose ways for HEC members to become involved in public policy and/or legislation regarding ethical issues.

Case

In early January 2011, 85-year-old Albert Barnes was actively dying from multi-organ system failure and end-stage dementia in the intensive care unit at Park Nicollet Methodist Hospital in Minneapolis. He had end-stage respiratory distress requiring mechanical ventilation, endstage renal failure, recurrent pneumonias, a recent history of seizure activity, recurrent urinary tract infections, ventriculoperitoneal shunt infections, and multi-drug resistant bacteremia. He received nutrition via a surgically implanted percutaneous endoscopic gastrostomy tube. He was neurologically unresponsive.

Mr. Barnes had multiple episodes of pulseless electrical activity between June 12, 2010 and December 1, 2010 while hospitalized at another local hospital, Hennepin County Medical Center. He was discharged home on December 25, 2010, only to be admitted that same day via ambulance to Methodist Hospital. This was Mr. Barnes’ 78th emergency ambulance transport over the past 9 years from his home in rural Minnesota to a healthcare facility in the Twin Cities region.