End of Life Decisions: Ethics in clinical practice, research and policy

Call for Abstracts closed March 15

A preliminary programme for the sessions will be published after March 20.

Death is the most personal and yet impersonal event in our lives. Death is necessarily experienced alone, but we are not supposed to die on our own. It affects people around us. Staff, relatives and legislators all have an idea of how this death is to occur, with whom and how it is to be handled.

This symposium concerns ethics at the end of life. Is there a good death? Who should define what a good death is? What need is there for regulations? How do we conceptualize our hopes and fears of death and dying?

This is a multi disciplinary research symposium. End of life decisions have both ethical, social and legal aspects and we welcome abstracts from scholars in all disciplines. Abstracts can span from proposals to published papers and case reports.

We invite scholars from all disciplines to investigate the moral dilemmas associated with these and other end of life decisions in clinical practice, research and policy.

We now call for abstracts and welcome all contributions. The symposium focuses on clinical 1) practice, 2) research and 3) policy. The first day of the symposium consists of keynote lectures and plenary discussions. The second day of the symposium consists of presentations in parallel sessions.

Submission deadline: March 15, 2009

Send your abstract to: crb@crb.uu.se; josepine.fernow@crb.uu.se

Abstracts should be submitted in .doc or .docx format, 250 words.

Send your abstract to:
crb@crb.uu.se; josepine.fernow@crb.uu.se

Abstract form >

Submission deadline March 15, 2009

Focus I: End of life decisions in clinical practice

Clinicians face difficult questions when patients do not respond to treatment. In this section we ask when it is appropriate to shift focus from curative to palliative treatment and whether palliative treatments are better than ordinary symptom control. When is it right to offer treatment that has shown only anecdotal evidence? Experimental treatment may be seen as offering a possibility of not giving in and may contribute to the patient's quality of life, but it may also be regarded as something imposed on patients and their families by doctors who are not prepared to give up. Perhaps nurses and doctors perceive these decisions differently. Would a doctor be more eager to find a diagnosis? Perhaps at the cost of a patient's quality of life? What role should relatives play in these decisions and are there economic factors that we should take into consideration?

Focus II: End of life decisions in clinical research

Clinical research on patients at the end of life can be difficult and such research is scanty, however, much needed. In this section we ask how clinical research on dying patients can expand and improve, and on what terms such research should be conducted. What informed consent procedures are acceptable? Should we seek advance consent for research on those dying patients that are unable to give consent? Experimental drugs can hasten patients' deaths and increase their suffering. How do we find the balance between costs and benefits in studies that may help future patients but have very slim chances of benefiting subjects? A vast majority of patients for whom conventional therapy fails will not be helped by research participation. How do we ensure that patients desperate for a last chance of recovery aren't subjected to the therapeutic misconception and how do we make sure that they are not exploited when we enrol them in experimental protocols?

Focus III: End of life decisions in clinical policy

One way to meet the ethical challenges clinical practice raise is to develop policy documents and clinical guidelines. An example of this is the national guidelines for priority setting formulated by the Swedish National Board of Health and Welfare, prescribing that priorities should be made out of respect for human dignity, need, solidarity and cost efficiency. According to these guidelines, palliative care is highly prioritized, as it would otherwise constitute a breach of the principle of human dignity. Another example concerns the guidelines for DNR (Do Not Resuscitate) that prescribe when life-sustaining treatment may be withdrawn and what ethical concerns such decisions raise. In this section we ask what role such policy documents play in clinical practice. Are they of any practical help for clinicians in their daily work? How are guidelines and policy documents developed and implemented on the clinical level? And how are we to deal with the fact that different guidelines and policy documents sometimes give contradictory advice?