2024 Colorado Healthcare Ethics Forum Annual Conference

Check-in with registration staff and pick-up conference materials. Breakfast is provided.

Welcome by Carl Middleton, CHEF Immediate Past President and conference Co-chair and Opening remarks by Kathy Prue-Owens, PhD, RN, current CHEF President.

This program explores the idea that reducing health disparities is an ethical duty for both individuals and organizations in the healthcare space, including policymakers. This duty is rooted in ethical principles like justice, beneficence, and social responsibility, as well as in the recognition that all individuals have an inherent right to attain the highest level of health possible, in line with their human dignity.

Recognizing the profound impact health disparities have on individuals and communities, creates an imperative for healthcare providers, institutions, policymakers, and society to actively address and mitigate these disparities.

Objectives:

1. Engage in reflection about privilege and biases
2. Explain what health disparities are and their root causes
3. Frame the concept of health disparities within various ethical principles
4. Discuss general approaches to addressing health disparities
5. Consider challenges to addressing health disparities
6. Develop one action item to reduce health disparities in their particular work or social setting

Healthcare organizations typically have a strong commitment to serve their patients. How this happens is varied across the spectrum with regard to diversity, equity, and inclusion (DEI) considerations. Explore how leadership influences DEI issues in the workplace and culture of organizations:

Objectives
1. Why representation matters with regard to diverse leaders in an organization
2. What leadership attributes drive DEI initiatives and change culture
3. What leaders can do to remove barriers to advance DEI work
4. How internal policy changes affect an organization's response to DEI initiatives

Networking break.

Today more humans feel safe to present as their authentic selves. As this trend continues to develop, how are we, as a society and healthcare providers, providing understanding for those diverse humans? How are we establishing a safe space? How are we establishing and affirming space? How are we providing an inclusive space? Finally, how are providing an empowering space? Abraham Maslow identified the human hierarchy of needs in his paper "A Theory of Human Motivation" in 1943. Maslow described needs portrayed as a pyramid of ascension. A similar pyramid exists for the Transgender human as they strive for equality. How can the healthcare system embrace Transgender humans in their struggle for self-efficacy?

Objectives:

1. A more in-depth understanding of the Transgender human. 
2. How CIS privilege has obscured our vision.
3. How healthcare professionals impact Transgender humans.
4. Finally, how can we as a community support the Transgender human as they strive for self-efficacy? 

This session will address ethical issues within the culture of disability and through the lens of health equity. To do this, we must be Inspired and empowered to acknowledge our personal biases to foster cultural humility, and not overlook the importance of being mindful and intentional in our interactions, particularly when engaging with diverse communities.  This session encourages the focus of working alongside communities and meeting the most vulnerable where they are. We will discuss how to treat the most vulnerable without judgment, with dignity and respect, and through fostering a deeper understanding and connection. Furthermore, we will address the importance of advocating for reframing perspectives on promoting abilities and accomplishments within communities to facilitate positive outcomes for those we serve.

Objectives:

• Develop participants' awareness and understanding of personal biases and cultural humility through interactive exercises and discussions.
• Equip participants with practical strategies and tools to approach community engagement with mindfulness, intentionality, and sensitivity to diverse cultural contexts.
• Empower participants to advocate for and promote positive change in community narratives by reframing perspectives on abilities and accomplishments, ultimately fostering more inclusive and empowering environments for those they serve.

Lunch in Pavillion

Palliative and end-of-life (PEOL) care offer many benefits to those with life-limiting illness; however, older unhoused individuals face several structural barriers in accessing such care. This presentation will provide an overview of the structural challenges to addressing palliative needs for unhoused individuals and opportunities to improve care. Findings from a mixed methods study exploring social service and healthcare provider perspectives on the issue will be shared, as well as current ongoing local efforts to address the health needs of unhoused individuals.

1. Understand structural barriers to accessing palliative and end-of-life care among unhoused individuals
2. Consider how their own approaches or practices support unhoused individuals (if applicable) 
3. Identify potential solutions to better support the palliative needs of our unhoused neighbors. 

The business of medicine has resulted in record profits for healthcare organizations, drug companies and more recently, corporate equity firms. Those left behind include healthcare providers and most concerning and worrying, the patients. Despite the revolution of Obamacare, more and more barriers to healthcare are arising all of the time. As always the Emergency Department is left to serve as the failsafe but even there, cracks are showing.

Objectives:

• Understand the barriers to healthcare that patients face every day.
• Recognize the ethical questions raised by a model of healthcare that puts profits first.

Networking break.

Over the last two years, Colorado has seen a significant rise in undocumented migrants in need of healthcare services. While the marked increase in the migrant community creates financial and social questions around housing and work, they also raise ethical questions for healthcare professionals. This presentation will describe features of the migrant patient populations, identify concerns they present with, and finally, suggest ways to address clinical ethical questions that arise in providing care.

Objectives:

1. Describe what is driving the increase in the migrant patient population.

2. Identify what needs migrant patients might present with and how to create an environment in which their concerns can best be addressed.

3. Understand clinical ethics questions that emerge when caring for undocumented patients.

Join colleagues for a networking reception hosted by the Center for Bioethics and Humanities, University of Colorado Anschutz Medical Campus
• During the reception, guests will visit tables showcasing programming such as:
• Gallery exhibits
• Raw Materials by NedRa Bonds
• 7,000 Babies: The Legacy of Justina Ford, MD
• Virtual Ethics Grand Rounds
• Research Grand Rounds • Holocaust, Genocide, and Contemporary Bioethics Program
• Pharmacy Ethics Series
• National Collaborative on Humanities & Ethics in Dentistry

The CU Center for Bioethics and Humanities is an academic center based at the University of Colorado that serves as a hub for interdisciplinary research, education, and discussions around ethical issues in healthcare and the life sciences.

Some of the key services and resources the Center provides that could benefit attendees of the Colorado Healthcare Ethics Forum annual conference include:

Education and Training Programs:
The Center offers courses, seminars, and training sessions on bioethical topics tailored for different audiences like healthcare professionals, researchers, students, etc. Conference attendees could learn about these educational opportunities.

Ethics Consultation Services:
The Center has bioethics experts and clinical ethicists who provide consultation services to hospitals, research institutions, and others navigating complex ethical dilemmas. Attendees could learn about accessing these consultation resources.

Research and Scholarship:
Faculty and staff at the Center conduct original research on pressing bioethical issues. Their research findings and publications could inform discussions at the conference.

Policy Development:
The Center may provide guidance on developing institutional policies and protocols related to ethical conduct of research, clinical care, organizational ethics, etc. which could be valuable for institutions represented at the conference.

Public Outreach and Events:
The Center hosts lectures, panel discussions, conferences and other public events around bioethics topics that attendees could be made aware of and participate in.

By having representatives from the CU Center present at the Healthcare Ethics Forum, attendees could directly learn about the Center's activities, resources, expertise and perspectives applicable to their own work in clinical ethics, research ethics, organizational ethics and policy.

Check-in with registration staff and collect any conference materials. Breakfast provided until 8:30am.;

The program will define the Social Justice Model and its relevance to healthcare. Social Justice model offers a framework for addressing inequities in healthcare and promotes health equity for all patients regardless of their cultural background or socioeconomic status. By examining the intersections of race, class, gender, and other social determinants of health, we will uncover how systemic inequities impact the five principles of the social justice model: access, equity, participation, diversity, and human rights. The five principles of the Social Justice can transform healthcare delivery, ensuring equitable access and outcomes for all. Social Justice in healthcare is about ensuring that everyone can live a healthy life and receive high-quality care regardless of their background or circumstances. As a society, we are responsible for our responsiveness to the systemic inequities in healthcare and improving the experience of our patients.

Objectives:

1. Gain a comprehensive understanding of the principles of a Social Justice Model as a method for identifying inequity and bias healthcare.
2. Identifying the barriers to applying the five principles of the Social Justice Model.
3. Examining the issues of health inequity for an under-resourced or marginalized population.
4. How can we as a community promote, support, and apply the Social Justice Model in healthcare.

This lecture addresses "twin aims" theories of health and social justice. Specifically, the lecture will ground the concept of health equity in a rigorous account of justice that emphasizes the twin aims: improving overall population health and compressing health inequity. The talk explains why a robust framework is necessary, explains why health interventions often fail the twin aims approach, and justifies the twin aims account as an ethically optimal approach to advancing health equity.

The talk will offer some practical examples of twin aims interventions in health policy and health professional practice, and tie the approach to key anti-oppressive efforts that aim to counter structural violence in the health professions.

Objectives:

• Explain the concept of a twin-aims approach to health and social justice;
•  Identify two reasons why a twin aims approach is important to advancing health equity; and
• Identify two examples of health interventions that satisfy a twin aims approach. 

Break

Review of world, US & CO black maternal and infant mortality. With calls to action.

Objectives:

• Learn about worldwide/US and Colorado MMR Black infant mortality rate 
• Identify solutions 
• Identify next steps 

This lecture will discuss ethical concepts that apply to bias and discrimination in healthcare affecting individuals in the US based on their citizenship and nationality.

1. Describe the impact of healthcare bias and discrimination based on citizenship and nationality, on individuals, communities, and society.
2. Describe the ethical principles that apply to citizenship and nationality bias and discrimination in healthcare.

Buffet lunch with colleagues.

Join us for an insightful conference presentation exploring the "Urban Underserved" class at RVUCOM. This transformative two-semester enrichment track prepares medical students to serve diverse and vulnerable populations adeptly. This course not only educates students about the unique healthcare needs of refugees, homeless individuals, veterans, and the LGBTQ community in the Metropolitan Denver area but also deeply immerses them in the complexities and rewards of working with these underserved groups.

Our presentation will focus on the experiential learning and personal growth our students achieve through their involvement in the class, confronting challenges such as PTSD, addiction, and language barriers that complicate healthcare delivery.

The session will highlight how the course integrates clinical experiences with a strong foundation in the social determinants of health, enhancing students' abilities to navigate and address issues like income insecurity, food scarcity, and employment challenges that often intersect with health outcomes.

This program not only augments students' medical education but also enriches their perspective on global health and social responsibility. By attending, you will gain insights into how future healthcare professionals are being equipped to deliver compassionate and competent care to some of the most marginalized communities, ultimately shaping them into more empathetic, effective practitioners.

Objectives:

Understand the Unique Challenges: Gain a comprehensive understanding of the specific healthcare needs and challenges faced by underserved populations such as refugees, homeless individuals, veterans, and LGBTQ communities in urban settings. Engage with Real-World Outcomes: Hear first-hand accounts from students about their transformative experiences and the practical skills they have acquired, which they can apply in their future medical practices.

This session will focus on income as a social determinant of health by integrating both lecture and activities. Inequities in the health of our communities consistently exist for people with lower incomes due to income as a contributing factor to health outcomes and as a factor inter-related to other social determinants of health. For health professionals to address health equity, it is critical to understand the connection between income and health, both through data and the root causes of these inequities, or the “why” of income inequity. Participants will learn about the systems that impact health inequities in both healthcare and the community and will be challenged to think through the systems in which they operate and work through a process to re-design these systems, connecting clinical interventions to community context and community interventions. We will look at the socioecological model for health and identify ways that participants can engage to shift inequities as professionals and as members of their own communities. Participants will leave feeling as though they are part of the solution to shift the status of health outcomes for people of lower incomes!

Objectives:

By the end of this presentation, participants will:

1.  Explain income as a social determinant of health;
2. Understand the systems that impact income-based health inequities and how to re-design to support lower-income community members;
3. Bridge healthcare interventions with community interventions to support whole-person health;
4. Understand ways to engage to remove income inequities 

Until recently, people with disability have historically been excluded from equity and diversity conversations in healthcare. This has perpetuated the long standing, structural ableist conditions in our healthcare system and society. The presentation will include examples of how historical ableist views are present in today' healthcare setting and teams, and the initial steps needed to advance equitable and just healthcare for people with disabilities.

Objectives:

1. Define the social model of disability and its role in understanding and addressing ableism in healthcare.
2. Identify actions healthcare teams can take to ensuring equitable and just delivery of care to patients with disabilities.