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Health Care Professionals Participating in Torture: An Ethical Interrogation

LMU BIOETHICS INSTITUTE PRESENTS

Health Care Professionals Participating in Torture: 
An Ethical Interrogation

Presentation by Dr. José Quiroga, M.D.
Response by Professor Jonathan Rothchild, Ph.D.

Wednesday April 8th at 7pm
Reception to follow

Roski Dining Room, University Hall 1640, Loyola Marymount University

The recent publication of the Senate Intelligence Committee report on the use of “enhanced interrogation techniques” by the U.S. government, during the so called “war on terror” (2001-2006), has brought to light the reality of health care professionals’ participation in torture. Not only medical doctors, but also psychologists and psychiatrists were found to be involved in both the design of torture programs and the actual practice of torture. Such discovery raises a host of questions for health care professionals and society at large. More specifically, how can health care professionals reconcile the commitment to the principle of “do no harm,” traditionally considered the cornerstone of medical ethics, with involvement in torture programs? Is such commitment, sworn by every health care professional, only a negotiable promise that can be rescinded by society or government for security purposes, or does it belong to the very fabric, one could say, the “internal morality,” of medical professionalism?

José Quiroga, M.D., a cardiologist, is co-founder and director of medical services at the Program for Torture Victims (PTV), and serves as a vice-president of the International Rehabilitation Council for Torture Victims (IRCT).  A native of Chile, Dr. Quiroga worked as a personal physician to Chilean president Salvador Allende.  After the coup d’état of 1973, he fled his country and became a professor in the Department of Public Health at UCLA.  Since then, he has dedicated his life to the treatment of torture victims, becoming a leading spokesperson on the issue both nationally and internationally.  Among other publications, he has co-authored a definitive and comprehensive study of the ongoing global work against torture: Approaches to torture rehabilitation: a desk study covering effects, cost-effectiveness, participation, and sustainability (2001).

Jonathan Rothchild, Ph.D. is Associate Professor and Chair of the Department of Theological Studies at Loyola Marymount University.

Bioethics Conference on Brain Death

THE SOUTHERN CALIFORNIA BIOETHICS COMMITTEE CONSORTIUM (SCBCC)

IN COLLABORATION WITH THE BIOETHICS INSTITUTE OF LOYOLA MARYMOUNT UNIVERSITY

PRESENT

“Brain Death” : Facilitating Family/Hospital Dialogue about Death by Neurological Criteria

A half-day conference for healthcare professionals, bioethical scholars, policymakers, and the public

Sunday, January 18, 2015 | 8 a.m. to 12:45 p.m.

Event Location:

Ahmanson Auditorium, University Hall 1000
1 LMU Drive
Los Angeles, CA 90045

Parking:

The most convenient on-campus parking is available below University Hall:  Enter campus via Lincoln Blvd by turning onto LMU Drive. Pass the security kiosk and turn into the first parking entrance (P2/P3) on your right. Parking is free on Sundays.

Visitor Guide:

Download Visitor Guide for driving directions and campus map to this event: Brain Death Conference_Visitor Guide

8:00-8:30am Registration & Breakfast
Continental breakfast served in MacIntosh Center, University Hall 3900
8:30-8:45am Welcome & Introduction
Welcome by Director of Bioethics Institute, Roberto Dell’Oro, Ph.D. Introduction to the conference by Paul Schneider, M.D.
8:45-9:15am Rabbi Jason Weiner, BCC
Dialoguing with the Orthodox Jewish community on the subject of death by neurological criteria
9:15-9:45am Andy Lampkin, Ph.D.
Dialoguing with the African American community on the subject of death by neurological criteria
9:45-10:00am   Break
10:00-10:30am Neil Wenger, M.D., M.H.P.
Is there a best-practice for how we interact with families about death by neurologic criteria?
10:30-11:30am Thaddeus Pope, Ph.D., J.D.
What is reasonable accommodation and are we doing it?
11:30-12:45pm Panel Discussion
Moderated by Malcolm Shaner, M.D., F.A.A.N. Panelists include the above presenters as well as Roberto Dell’Oro, Ph.D. Audience will have an opportunity to raise questions from the day’s presentations.

Rabbi Jason Weiner, BCC

Rabbi Jason Weiner Photo CSMC 2012

Rabbi Jason Weiner, BCC, serves as the senior rabbi and manager of the Spiritual Care Department, where he is responsible for the chaplaincy team and all aspects of spiritual care at Cedars-Sinai. Rabbi Weiner initially came to Cedars-Sinai to serve as the Jewish chaplain. He previously had been the assistant rabbi at Young Israel of Century City in West Los Angeles.

Rabbi Weiner earned his rabbinic ordination in 2006 at Yeshivat Chovevei Torah Rabbinical School in New York City, as well as an ordination from Rav Zalman Nechemia Goldberg in Jerusalem. He also holds a master’s degree in Jewish history from the Bernard Revel Graduate School at Yeshiva University and is currently completing a master’s in Bioethics & Health Policy at Loyola University, Chicago.  Rabbi Weiner has completed four units of clinical pastoral education and is a board certified chaplain through the National Association of Jewish Chaplains.

Rabbi Weiner serves as a vice-president of the Southern California Board of Rabbis and was honored with the Rabbinic Leadership Award from the Orthodox Union in 2011.  He is a member of the Cedars-Sinai End of Life Committee, the Organ Donor Council and the Bioethics Committee, where he serves on its internal advisory board. Rabbi Weiner frequently serves as a scholar-in-residence at conferences and synagogues throughout the nation on topics related to Jewish ethics, health and wellness.  He is the author of Guide to Traditional Jewish Observance in a Hospital and has published more than two dozen scholarly and popular articles.

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Andy Lampkin, Ph.D.

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Dr. Lampkin is an Associate Professor of Religion – Ethical Studies at Loma Linda University where he teaches courses on biomedical ethics, Christian social ethics, ethics and health disparities. He is also an Associate Scholar at the Center for Christian Bioethics, and his research investigates ethical issues in health care, race and health care, social roles of religion, religion and health activism. Dr. Lampkin received his Ph.D. in Religion from Vanderbilt University, where he specialized in Biomedical Ethics.

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Neil Wenger, M.D., M.H.P.

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Neil S. Wenger is Professor of Medicine in the Division of General Internal Medicine at UCLA and a consulting researcher at RAND. He is director of the UCLA Healthcare Ethics Center and is chair of the Ethics Committee at the UCLA Medical Center. He also is director of the NRSA Primary Care Research Fellowship in the UCLA Division of General Internal Medicine and Health Services Research. Dr. Wenger is an active general internist and carries out research in the empirical study of clinical ethics, care of and decision making for the older patient, and quality of health care. He directs the Assessing Care of the Vulnerable Elders project, which has developed a quality-of-care assessment system for vulnerable older persons and interventions to improve care for this group. Other areas of interest include medication adherence, teaching clinical ethics, and measuring the quality of end-of-life care.

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Thaddeus Pope, Ph.D., J.D.

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Thaddeus Pope is Director of the Health Law Institute and Associate Professor of Law at Hamline University. He is also an Adjunct Professor with the Australian Centre for Health Law Research at Queensland University of Technology and an Adjunct Associate Professor for the Alden March Bioethics Institute at Albany Medical College.  This year, Professor Pope is chair-elect of the Association of American Law Schools Section on Law, Medicine, and Health Care.

In his scholarship, Professor Pope focuses on three main areas: (1) patient rights, (2) end-of-life medicine and (3) public health ethics. He has over 100 publications in: law journals, medical journals, and bioethics journals. His articles have been published in the New England Journal of Medicine, JAMA, Chest, and the American Journal of Bioethics.  Professor Pope coauthors the treatise: The Right to Die: The Law of End-of-Life Decisionmaking. He also authors a regular column for the Journal of Clinical Ethics.

Professor Pope’s engagement with these issues goes well beyond academic scholarship. For example, he has participated both as appellate counsel and as expert witness in healthcare litigation. He is a voting member of MEDCAC, the Medicare Evidence Development & Coverage Advisory Committee.  He has served as legal consultant to several Policy Statement groups of the American Thoracic Society. And he co-chairs the Minnesota Task Force on Physician Orders for Life Sustaining Treatment at the Minnesota Medical Association.

More Information | Curriculum Vitae

Malcolm Shaner, M.D., F.A.A.N.

Shaner Headshot

Malcolm Shaner is Physician Director of the Bioethics Program in Kaiser Permanente Southern California, a full-time neurologist and Chief of the Department of Neurology at Kaiser Permanente West Los Angeles Medical Center, Clinical Professor of Neurology at UCLA and a member of the Ethics Section as a Fellow of the American Academy of Neurology. He is the author of peer-reviewed articles and text chapters in neurology and ethics.

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Roberto Dell’Oro, Ph.D.

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Dr. Roberto Dell’Oro is the Director of the Bioethics Institute with more than 15 years of experience as bioethics scholar and professor. He is especially interested in anthropological themes at the crossroad of theology and philosophy and has written three books: Health and Human Flourishing: Religion, Moral Anthropology, and Medicine (Washington: Georgetown University Press, 2006), Esperienza Morale e Persona (Rome: Gregorian University Press, 1996) and History of Bioethics: International Perspectives (San Francisco: International Scholars Publications, 1996), translated two books from German, and has had worked published in national and international journals, such as Theological Studies; Health Progress; Medicine, Health Care and Philosophy; The Journal of Contemporary Health Law and Policy; INTAMS Review; Rivista di Teologia Morale; and Vida y Etica. In addition, he serves on bioethics committees, including serving as Chair for the committee at Saint John’s Medical Center, Santa Monica, CA.

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The Southern California Bioethics Committee Consortium (SCBCC) is a group of health care professionals who meet regularly to discuss the medical, legal, and ethical dimensions of “doing” bioethics in Southern California. Membership includes individuals from Ventura, San Bernardino, Riverside, Los Angeles, Orange and San Diego Counties.

For the past several years, Loyola Marymount University has been on the forefront of bioethics education within the Los Angeles community. Our commitment is to challenging curricular offerings at the graduate and undergraduate levels, expanding research initiatives for interdisciplinary collaboration of faculty across various Departments and Colleges, and renewing our involvement in the larger community through public lectures, symposia, and a critical contribution to the most controversial ethical issues of the day.

Power Point Presentations


Other Handouts:

“Primary California Legal Authorities on Accommodating Objections to the Determination of Death by Neurological Criteria”

This handout was prepared by Thaddeus Pope, JD, PhD in preparation for the January 2015 conference and contains the following documents:

  1. California Uniform Determination of Death Act, CAL. HEALTH & SAFETY CODE § 1254.4 (1982).
    ->Law of determination of death by circulatory-respiratory and neurologic criteria
  2. CAL. HEALTH & SAFETY CODE §§ 7180-81 (2008) (aka A.B. 2565).
    -> Law providing reasonable accommodation of religious, cultural, or other values and concerns of brain-dead individuals or their families
  3. California Department of Health, Letter to General Acute Care Hospitals, Hospital Brain Death Policy (Jan. 20, 2009).
    -> In some ways a restatement of #1 & 2
  4. Dority v. Superior Court, 145 Cal. App. 3d 273 (1983).
    -> A California case that deals effectively with sustaining a diagnosis of brain death and removing life support from a child whose parents’ refusal is judged contrary to the interests of the child or the hospital and other patients.  It imposes a limit on the duration of the reasonably brief period of accommodation of relatives of a brain-dead individual and perhaps a limit on reasonable limits to accommodate contrary religious or cultural practices and concerns.
  5. Cal. A.B. 3311 (1986) (Katz).
    -> Assembly Bill 3311 substantially permits (or, if not law, would have permitted) religious or moral beliefs or convictions to override a determination of death determined by neurologic criteria as is the case in New Jersey.   This article is quite relevant to our discussion of brain death and its understanding by a religious and cultural group (our speakers on the Jewish and African-American perceptions are examples and not meant to be exclusive of religious and cultural beliefs) and of the reasonable accommodation for disparate views.
  6. Thaddeus Mason Pope, Legal Briefing: Brain Death and Total Brain Failure, 25(3) JOURNAL OF CLINICAL ETHICS 245-257 (2014).
    ->Pope’s 2014 Journal of Clinical Ethics review considers the many concerns regarding the determination of death by neurologic criteria. These include the discrepancy between the legal and biologic definitions of death, the varied accommodation of religious or moral or other beliefs that neurologically devastated individuals are not dead, and by whom and how neurologic death should be determined. 

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The BEST Way to Say Goodbye – Recommendation from Sue Gilmer, ’16

Th​is video portrays poignant stories of patients that illustrate the need for diligent, strategic Advance Care Planning: · Robin Williams: Was a “key factor” in his decision to commit suicide experiencing hallucinations or other symptoms of early Lewy Body Dementia? Might he have suffered from the “Dementia Fear”? · Brittany Maynard: She admitted this “did […]