Ethics Section

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  • 1.  Newly formed Ethics Section

    Posted 21 days ago

    Dear Ethics Section members, It has taken a while to make the change from Committee to Section, but the transition has been completed - and this is the first transition year of the newly created SCCM Ethics Section! As chair during the transition year, I have named 3 people as Section Officers for this initial year, who have been actively engaged with the field of Ethics and who have not previously held ethics leadership roles within SCCM:  Mithya Lewis-Newby (Peds), Shahla Siddiqui (Anesthesia) and Jessica Turnbull (Peds).  We will have a kick-off meeting with Colette, Donna, me and the 3 section officers in June, and will plan for a meeting for Section membership later this year.  

    Ongoing projects:

    3 proposals for Webinars/Podcasts that are being submitted for future consideration. Topics: ECMO and ethical considerations, Professionalism in the ICU, Resuscitation-related Conversations with ICU patients who have pre-existing "DNAR" orders. 

    A small workgroup is working on a written update about the 'medical futility' debate - the proposal for this was submitted by me and approved in 2025. 

    Ethics section members who have an interest in being actively involved should feel free to start thinking about topics for congress proposals, podcasts, webcasts, etc. and feel free to reach out to any of us either via this Connect forum, or via email with specific ideas.

    Thank you and best regards!

    Preeti R. John



    ------------------------------
    Preeti R. John MD, MPH, FACS, FCCM, HEC-C
    Surgeon, Intensivist, Certified Healthcare Ethics Consultant,
    Veterans Affairs Maryland Health Care System,
    Clinical Associate Professor, Dept. of Surgery,
    University of Maryland School of Medicine,
    Baltimore, MD
    ------------------------------


  • 2.  RE: Newly formed Ethics Section

    Posted 19 days ago
    Thanks Preeti
    Hopefully, we will have robust engagement and discussion on topics that affect our daily practice. 

    Shahla Siddiqui, MBBS, MSc, FCCM.
    Associate Professor,
    Harvard Medical School,
    Department of Anesthesia, Critical Care and Pain Medicine,
    Co-Chair Ethics Advisory Committee,
    Beth Israel Deaconess Medical Center,
    Course Director, HMS Advanced Clinical Elective in Respiratory/Surgical ICU
    Member, HMS Center for Bioethics,
    Boston, MA, USA
    Vice Chair of the Committee on Critical Care Medicine, 
    American Society of Anesthesiology







  • 3.  RE: Newly formed Ethics Section

    Posted 18 days ago

    Hi everyone, I've heard from colleagues who have shared their interest in Ethics and asked about the following:

    1) Ongoing medical futility related project. We have a workgroup currently working on this, and it is in process and not ready for distribution. Once we finalize the writing, it will need to be submitted to Council for review. So I would refer you to the existing SCCM publications and numerous other publications that currently exist in the literature about this topic. It will be a while before our work product is completed!

    2) Interest in Ethics. It's great that we have people who are interested, and actively engaged in Ethics at your facilities. 

    Best way to get involved: submit a Podcast / Webinar proposal, or share a specific idea for a future Congress session proposal. The forms are accessible via this SCCM website, and if you cannot find it, please post a message here so that SCCM section liaisons can assist. Colette Punda is the Ethics section liaison. 

    3) Someone asked about Guidelines and other specific topics such as moral distress. This is the link for SCCM guidelines - https://www.sccm.org/clinical-resources/guidelines/guidelines   Lots of useful resources here, and if you don't find specific topics, an online search would be best.

    4) Someone requested me to email them to provide updates about the Section's work - I unable to respond to each person individually. This is the forum that we will use to share what we are currently planning / working on. We will post something here as soon as we can figure out when to schedule a section-related discussion/meeting. We will meet later this month with section officers and will get official SCCM guidance about Section-related processes.

    Please feel free to post here - thank you for your interest and engagement! 



    ------------------------------
    Preeti R. John MD, MPH, FACS, FCCM, HEC-C
    Surgeon, Intensivist, Certified Healthcare Ethics Consultant,
    Veterans Affairs Maryland Health Care System,
    Clinical Associate Professor, Dept. of Surgery,
    University of Maryland School of Medicine,
    Baltimore, MD
    ------------------------------



  • 4.  RE: Newly formed Ethics Section

    Posted 18 days ago

    Additional info for those who asked about the "medical futility" topic:

    SCCM Publications:

    1.      Consensus statement of the Society of Critical Care Medicine's Ethics Committee regarding futile and other possibly inadvisable treatments. Crit Care Med. 1997 May;25(5):887-91. doi: 10.1097/00003246-199705000-00028. PMID: 9187612.

    2.      Bosslet GT, Pope TM, Rubenfeld GD, Lo B, Truog RD, Rushton CH, Curtis JR, Ford DW, Osborne M, Misak C, Au DH, Azoulay E, Brody B, Fahy BG, Hall JB, Kesecioglu J, Kon AA, Lindell KO, White DB; American Thoracic Society ad hoc Committee on Futile and Potentially Inappropriate Treatment; American Thoracic Society; American Association for Critical Care Nurses; American College of Chest Physicians; European Society for Intensive Care Medicine; Society of Critical Care. An Official ATS/AACN/ACCP/ESICM/SCCM Policy Statement: Responding to Requests for Potentially Inappropriate Treatments in Intensive Care Units. Am J Respir Crit Care Med. 2015 Jun 1;191(11):1318-30. doi: 10.1164/rccm.201505-0924ST. PMID: 25978438.

    3.       Kon AA, Shepard EK, Sederstrom NO, Swoboda SM, Marshall MF, Birriel B, Rincom F. Special Article: Defining Potentially Inappropriate Treatment: A Policy Statement from the SCCM Committee on Ethics. Critical Care Medicine 44(9): 1769-1774. September, 2016. IF 6.312



    ------------------------------
    Preeti R. John MD, MPH, FACS, FCCM, HEC-C
    Surgeon, Intensivist, Certified Healthcare Ethics Consultant,
    Veterans Affairs Maryland Health Care System,
    Clinical Associate Professor, Dept. of Surgery,
    University of Maryland School of Medicine,
    Baltimore, MD
    ------------------------------



  • 5.  RE: Newly formed Ethics Section

    Posted 13 days ago

    Question I received in my Inbox: 

    Will the SCCM medical futility update have any specific points applicable to pediatrics? 

    Answer: Yes! Alex Kon, Pediatrician and current SCCM member who has published extensively, is part of the writing workgroup. Robert Truog, Pediatric Anesthesiologist, also a former SCCM member, (Director emeritus, HMS Center for Bioethics) is also part of the writing group. 



    ------------------------------
    Preeti R. John MD, MPH, FACS, FCCM, HEC-C
    Surgeon, Intensivist, Certified Healthcare Ethics Consultant,
    Veterans Affairs Maryland Health Care System,
    Clinical Associate Professor, Dept. of Surgery,
    University of Maryland School of Medicine,
    Baltimore, MD
    ------------------------------



  • 6.  RE: Newly formed Ethics Section

    Posted 18 days ago
      |   view attached

    Hello Ethics enthusiasts!

    I would love to have folks bounce of initiatives, projects, teaching or educational endeavors here for input from the section.

    I have started an Ethics Curriculum for our Anesthesiology residents at BIDMC, Boston and would love to hear more about similar initiatives around the country?

    Also attaching a paper I came across in JCRC which is relevant to decision making in the ICU and may be an interwsting read,

    Best

    Shahla



    ------------------------------
    Shahla Siddiqui, MBBS, MSc, FCCM.
    Associate Professor,
    Division of Critical Care Medicine
    Department of Anesthesia, Critical Care and Pain Medicine,
    Co-Chair Ethics Advisory Committee,
    Clerkship Director Advanced Clinical Electives,
    Respiratory -Surgical Intensive Care,
    Beth Israel Deaconess Medical Center,
    Harvard Medical School,
    Member, HMS Center for Bioethics,
    Boston, MA, USA
    Vice Chair of the Committee on CCM, 
    American Society of Anesthesiology
    ------------------------------

    Attachment(s)



  • 7.  RE: Newly formed Ethics Section

    Posted 13 days ago

    Thanks for posting this article, Shahla! 

    I appreciate how the authors address the concept of proportionality and agree that it allows for the contextual nuance that is integral in ICU decision-making.
    Also, they have quoted Alex Kon, our SCCM Pediatrician colleague who has written a great deal about decision making in the ICU!
    We encourage other colleagues in this section to share articles that may be of interest to the ICU community!


    ------------------------------
    Preeti R. John MD, MPH, FACS, FCCM, HEC-C
    Surgeon, Intensivist, Certified Healthcare Ethics Consultant,
    Veterans Affairs Maryland Health Care System,
    Clinical Associate Professor, Dept. of Surgery,
    University of Maryland School of Medicine,
    Baltimore, MD
    ------------------------------



  • 8.  RE: Newly formed Ethics Section

    Posted 11 days ago
    Hi!

    We have a general pediatrics residency ethics curriculum that is very learner-based in that the presenters are residents who are taking part in our Certificate of Distinction in Biomedical Ethics (https://www.vumc.org/cbmes/node/153). They give a noon conference about an ethics topic of their choice for their final project. I pair them up with a mentor to guide the writing of their lecture (either one of our other clinical ethicists, or our heme/onc, neonatology or heart failure MDs who core faculty at our Center for Biomedical Ethics and Society, https://www.vumc.org/cbmes/) and they give it to their colleagues. I also give a general "peds ethics primer" lecture at the beginning of each academic year.

    It's really cool to have an ethics curriculum. The audience gets really involved because they feel they have something important to say; it's not like I'm lecturing about a protein that only I have studied for 30yrs so nobody else can say anything intelligent about it, y'know?

    Admin Assistant: Laura Journey
    VUMC
    Q: Why is this email five sentences or fewer?