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HHS hosts seminar on substitute decision making by David Lea Oakville Beaver Staff Health 31 | Thursday, April 17, 2014 | OAKVILLE BEAVER | www.insideHALTON.com "Connected to your Community" If a loved one was in a terrible accident and taken to hospital, is there a point where they would want to be taken off life support? Halton Healthcare Services is asking residents to think about tough questions like this during a seminar on substitute decision making, which will be held Thursday, April 24 at the Oakville Trafalgar Memorial Hospital auditorium, 327 Reynolds St., The free event runs from 7-8:30 p.m. and features presentations by ethicists Eoin Connolly, Pat Hood-McNicol and Dianne Godkin of the Trillium Health Partners Regional Ethics Program. Ethicists within this program counsel family members who suddenly nd themselves in situations where treatment decisions for a loved one must be made, but the loved one is not capable of making the decision themselves. Three speakers The three speakers will discuss what a substitute decision maker is, when they are needed, who can be one and why it is so important for residents to make their medical treatment wishes known to their families ahead of time. Godkin noted there is no shortage of reasons to get people talking about this subject. "The stats tell us that about 70 per cent of the population is likely to experience a situation where they are not able to make their own treatment decisions and so they are going to need a substitute decision maker," she said. "Because of this, we think it is really important for people to understand what that role is and for them to understand how they are to make decisions." Godkin said sometimes people placed in the role of substitute decision maker believe they can make whatever treatment decisions they want for their relative. This assumption is incorrect, she said, as there are legal and ethical obligations for decisions to be made in keeping with any previous wishes the patient has conveyed, even if the family does not agree. Examples of some of the scenarios families could be faced with include whether a loved one would want to be fed with a feeding tube, whether they would want to risk a particular surgery or whether they would want to begin chemotherapy at a particular stage. Decisions not always about life and death Connolly said the decisions are not always life and death situations, but could be something like whether a parent with dementia would want to be placed in a longterm care facility. In all these scenarios the ethicists explain the options available to the substitute decision maker and attempt to arrive at a solution based on the patient's values, medical wishes and beliefs. As this process is made considerably more dif cult if the patient never expressed their wishes, Godkin is hoping the seminar will get people talking to their families about what they would want should the unthinkable happen. Who can serve as a substitute decision maker is another subject, which will be covered in the seminar. In the event of an emergency where no family members are immediately available, Connolly said the law allows medical staff to carry out the treatment they believe is appropriate. The stats tell us that 70 per cent of the population is likely to experience a situation where they are not able to make their own treatment decisions and so they are going to need a substitute decision maker. Because of this, we think it is really important for people to understand what that role is and for them to understand how they are to make decisions. Trillium Health Partners Regional Ethics Program ethicist Dianne Godkin Health Care Consent Act Beyond that, Connolly noted the Health Care Consent Act lists a hierarchy of people who will be approached to make treatment decisions if a patient cannot. "Usually it's the person's spouse or partner. There are other categories we look at. At the very top of the list is the guardian... or it could be the attorney for personal care," he said. If there is no spouse, the hospital usually looks to the person's children for a substitute decision maker. Connolly said problems can occur here because all children have equal decision making power and may have different ideas about what medical treatment their parent would have wanted. If all children do not agree with a treat- ment option, a public guardian trustee may be called on to make a decision or one or more of the children could apply to an independent body created by the Province known as the Consent and Capacity Board to become a substitute decision maker. The parent can also be approached to see if they have the capacity to appoint someone as their decision maker. Hood-McNicol said these problems could be easily avoided by a parent designating someone as their power of attorney for personal care ahead of time. "You never know what is going to happen," said Connolly. "It is better to be prepared." Anyone planning on attending the seminar is asked to RSVP to reserve a seat by calling Patient Relations at 905-338-4138. Follow Oakville Beaver staff on Twitter @OakvilleBeaver or @NewsHooked @DavidLea6 @JuliaLeReporter @Beaversports or @Halton_Photog Isn't It About Time For A Hearing Test??? Come And Visit An Independent, Caring Family Hearing Aid Clinic All Services, Sales, Hearing Tests, Programming, Repairs, Batteries, Home Visits Jennifer Nolan Wendy Caswell The Registered Nurses' Association of Ontario's Halton chapter is putting out the call for young artists for an upcoming contest. In a celebration of Nursing Week (May 12-18), the contest is asking children in the region what nursing means to them. "Nursing means something different to everyone," stated a press release. "For some, it's about crying tears of frustration or joy after helping to bring a life into this world, or providing comfort to someone about to pass on. For others, it means being on the receiving end of safe, compassionate, knowledgeable and ethical care." Interested participants are invited to submit artwork, which must be scanned and emailed, to RNAO. haltonchapter@gmail.com by May 1. Winners will be announced during Nursing Week celebrations. 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