Objectives

1. Describe ways that local or institutional-specific ethics policies have broadercommunity implications.

2. Explain why it is important for HEC members to educate the broader (not justinstitution-speciic) community about ethical policies.

3. Propose ways for HEC members to become involved in public policy and/orlegislation regarding ethical issues.

Case

In early January 2011, 85-year-old Albert Barnes was actively dying from multi-organ systemfailure and end-stage dementia in the intensive care unit at Park Nicollet Methodist Hospitalin Minneapolis. He had end-stage respiratory distress requiring mechanical ventilation, endstagerenal failure, recurrent pneumonias, a recent history of seizure activity, recurrent urinarytract infections, ventriculoperitoneal shunt infections, and multi-drug resistant bacteremia. Hereceived nutrition via a surgically implanted percutaneous endoscopic gastrostomy tube. Hewas neurologically unresponsive.

Mr. Barnes had multiple episodes of pulseless electrical activity between June 12, 2010 andDecember 1, 2010 while hospitalized at another local hospital, Hennepin County Medical Center.He was discharged home on December 25, 2010, only to be admitted that same day viaambulance to Methodist Hospital. This was Mr. Barnes’ 78th emergency ambulance transportover the past 9 years from his home in rural Minnesota to a healthcare facility in the Twin Citiesregion.