The first session of our new Bioethics Research Series featured four scholars from our UCSF Bioethics community – Jack Chase, MD; Anita Ho, PhD, MPH; Anna Chodos, MD, MPH, and Brianna Stein, MD – discussing practical and theoretical complexities in the care of people with decision-making impairment. The faculty covered a wide range of issues from preventative approaches for people at risk in an outpatient setting, shared-decision making with patients with limited capacity, a theoretical model for balancing beneficence/nonmaleficence and autonomy drawn from the experience of working in a safety net hospital, and considerations for shared-decision making in the post-acute setting. Much of the presentation worked to bring in the social context of the patient when considering capacity and balancing coercion with the urgency of a medical risk to the patient.
In the post-presentation discussion, participants considered the potential difference between capacity to make care decisions and capacity to be discharged and if these two situations fit within the same model. We also considered shared-decision making in the context of pediatrics and the overall goals of shared-decision making when not all ethically important aims can be achieved.
Related readings for this and future meetings are archived for members of the UCSF community at https://tiny.ucsf.edu/BioethicsRS.