November 14, 2006

Doctors tackle health care, ethics

The U of C’s MacLean Center for Clinical Medical Ethics held its 18th annual Dorothy J. MacLean Fellows Conference this weekend at Ida Noyes Hall. The event featured over 18 hours of programming with 25 speakers, as well as receptions, meals, and parties.

This year’s conference, which drew over 100 doctors, focused on health care reform and clinical ethics. Speakers addressed a wide range of topics, from the pragmatics of universal health insurance to the methodology of medical ethics research.

One panel focused on the unresolved issues of surrogate decision-making. Doctor Dan Brock, director of the Division of Medical Ethics at Harvard Medical School and author of the field’s landmark text, Deciding for Others, defended his work.

He outlined central dilemmas of surrogate decision-making, including the subjectivity of determining patient competence, the difficulty of choosing a proper surrogate, and a widespread bias toward continuing life support.

“There’s an assumption here that it is more serious to stop a wanted treatment than to continue an unwanted treatment,” Brock said. “It seems to me the bias should be in favor of stopping treatment.”

Doctor Alexia Torke, an M.D. fellow in medicine and bioethics at the U of C, discussed findings from a survey she is administering. Of the 129 physicians she has interviewed, only 11 percent say they have contact with a particular patient prior to that patient’s need for a surrogate decision-maker. These physicians estimate that 17 percent of patients cannot make their own decisions, underlining the importance of surrogate decision-making in the medical community, she argued.