Last Friday, three medical experts discussed the ethics of public involvement in health policy decision-making at the Harvard Clinical Ethics Consortium.
The panel of speakers, hosted by the Center for Bioethics at Harvard Medical School, included Erica Blacksher, a research professor at the University of Kansas; Julius J. Yang, medical director of Beth Israel Deaconess Medical Center; and Basel M. Talab, administrator of Winchester Hospital.
The discussion was moderated by Charlotte H. Harrison, an ethicist at Boston Children's Hospital, Jonathan M. Mallon, director of the HMS Center for Bioethics, and Leanne J. Homan, associate director of clinical ethics. It was Mr.
This debate addressed the extent to which the public should be involved in the formulation of health policy, particularly when the policy concerns patient care, and under what circumstances public involvement in these issues should be allowed. .
Mr. Blackshire argued that the public should be invited to deliberate on health issues.
“The idea is that deliberation has transformative potential,” Blacksher said. “Perspectives can evolve in light of evidence, by being exposed to viewpoints that are completely different from your own, or simply by having a chance to think about why you think the way you do.” there is.”
Tarab and Yang expressed concerns about this approach and asked Blackshire how policymakers can ensure they understand the complex issues faced by patients.
“People will surprise you,” Blackshear replied. “We're investing millions of dollars into these very sophisticated interventions that are meant to improve people's health. And because we're not actually talking to people, , they very often simply fail.”
Dr. Yang spoke to the Patient and Family Advisory Committee, a hospital committee made up of patients, their families, and health care professionals, and spoke about its role in promoting patient involvement in medical decisions.
“The establishment of PFAC was aimed at promoting patient and family participation in hospital care, decision-making, information sharing, and policy and program development,” he said.
To better integrate patients and their families into the decision-making process, Yang said Beth Israel Deaconess Medical Center currently has three PFACs: one hospital-wide, one for adult intensive care, and one for neonatal intensive care. It was pointed out that it had been established.
“This has really been a game-changer within our hospital,” Yang said.
Dr. Tarab discussed the difficulty of balancing diverse patient perspectives through PFAC, noting that significant member engagement can result in an unrepresentative organization.
“The challenge we face when selecting members to join PFAC is how to balance voices and perspectives within these councils,” he said. “The bigger question is: Are we truly representing the community among our council members?”
Tarab suggested other ways to solicit public input, such as patient surveys, but said there are additional difficulties, such as limiting the view to only those who have already visited the hospital.
“We usually only get the perspective from the patient and not necessarily the broader perspective of the general public,” Talab says.
All three experts emphasized the importance of public engagement, despite disagreements about how to do so effectively.
“Knowing what people's values are, knowing what people's concerns are, knowing how people think about risks and benefits, and figuring out what their values are is what we should do. “It can inform leaders' views about,” Blacksher said.
