Cross Cultural Perspectives on Decision Making in Medicine and Surgery

Through March 18, 2017

Begins
Mar. 17

Conference Co-Chairs (Surnames in Alphabetical Order)

Peter Angelos, M.D., Ph.D.
Linda Kohler Anderson Professor of Surgery and Surgical Ethics
Chief, Endocrine Surgery
Associate Director of the MacLean Center for Clinical Medical Ethics
University of Chicago Medicine

Yilei Mao, M.D., Ph.D.
Professor of Surgery, Department of Liver Surgery
Peking Union Medical College Hospital
Chinese Academy of Medical Sciences and PUMC

J. Michael Millis, M.D.
Professor of Surgery
Vice Chair for Global Surgery
Director, University of Chicago Transplant Center
Chief, Section of Transplantation
University of Chicago Medicine

Mark Siegler, M.D.
Lindy Bergman Distinguished Service Professor of Medicine and Surgery
Executive Director, Bucksbaum Institute for Clinical Excellence
Director, MacLean Center for Clinical Medical Ethics
University of Chicago Medicine

Xiaomei Zhai, Ph.D.
Dean and Professor, School of Humanities and Social Sciences
Peking Union Medical College
Executive Director, Center for Bioethics
Chinese Academy of Medical Sciences and Peking Union Medical College


会议组织者(按姓氏字母顺序排列)


Peter Angelos, M.D., Ph.D.
芝加哥大学医院
Linda Kohler Anderson外科和外科伦理学教授
内分泌外科主任
MacLean临床医学伦理研究中心副主任

毛一雷, M.D., Ph.D.
北京协和医院,北京协和医学院
肝外科教授
中国医师协会肝脏外科医师委员会副主任委员

J. Michael Millis, M.D.
芝加哥大学医院
外科学教授
全球外科副主席
芝加哥大学移植中心主任
芝加哥大学医院移植科主任

Mark Siegler, M.D.
芝加哥大学医院
Lindy Bergman杰出内科和外科学教授
Bucksbaum卓越临床研究所执行主任
MacLean临床医学伦理研究中心主任

翟晓梅, Ph.D.
北京协和医学院人文和社会科学学院院长、教授
中国医学科学院/北京协和医学院生命伦理学研究中心执行主任                              

 

About the Conference


The focus will be on the doctor-patient relationship and how it differs between specialties, surgery, medicine and pediatrics and between the US and China.
This broad topic allows us to look at how doctors and patients make decision for both medical and surgical treatments. We would explore questions such as whether the concept of “shared decision making” has relevance outside of the Anglo-American medical contexts.
We will look at how surrogate decisions are made in different settings such as for neonates as well as for elderly patients.   A Western principle of the Doctor-patient relationship is respecting the autonomous choices of patients. This may differ in different cultures and different settings. Similarly, exploration of ‘presumed consent” for medical emergencies such as CPR or emergency surgery can be addresses. (e.g. in trauma in different cultural settings.)
Using an interactive case based format, in collaboration with our surgical, medical, and bioethics colleagues in Beijing, the specific topics emphasize different approaches to these issues across Western and Chinese cultures.

会议概要


本次会议将聚焦中美两国包括外科、内科与儿科等不同科室中医患关系的异同。

借此话题我们将探讨医生与患者在面对内科与外科决策时的思路,并探索「参与式决策」(Shared Decision Making)在英美国家医疗背景以外的适用性。

我们的另一话题是新生儿与老年等患者中的代理决策情况。西方的医患关系中尊重患者自主决定的原则可能并不适用于不同的文化与临床情况。而诸多医疗急救如CPR或急诊手术中的「推定同意」(Presumed Consent)也会在本次会议中谈及(如不同文化环境下的外伤处理)。

本次会议采取互动对的形式,联合外科、内科与生命伦理学的同仁共聚北京会场,这一特殊话题的讨论将向我们展示西方与中国文化间决策方式的不同。

CONFERENCE AGENDA

FRIDAY, MARCH 17

Session I  OPENING SESSION

MODERATOR: J. MICHAEL MILLIS, M.D.
Professor of Surgery
Vice Chair, Global Surgery
University of Chicago Medicine

1:00-1:15 PM   Welcome and Introductions

Co-Chairs:
Xiaomei Zhai, Ph.D.
Dean and Professor, School of Humanities and Social Sciences
Peking Union Medical College
Executive Director, Center for Bioethics
Chinese Academy of Medical Sciences and PUMC

Peter Angelos, M.D., Ph.D.
Linda Kohler Anderson Professor of Surgery and
Surgical Ethics Chief
Endocrine Surgery
Associate Director of the MacLean Center for Clinical Medical Ethics
The University of Chicago Medicine

J. Michael Millis, M.D.

1:15-2:00 PM   KEYNOTE ADDRESS 
Cross-cultural Views on Difficult Decisions Near the End of Life

PRESENTER: BERNARD LO, M.D.
President & CEO
The Greenwall Foundation
Professor of Medicine Emeritus
Director Emeritus, Program in Medical Ethics
University of California San Francisco

Q &A: 10 minutes


2:00-2:45 PM   Cross-cultural Views on Ethical Decisions in the Emergent  
Context in Medicine and Surgery

PRESENTER: QIU RENZONG, Ph.D.
Chair, Academic Committee, Center for Bioethics, Chinese Academy
of Medical Sciences/Peking Union Medical College
Adjunct Professor, School of Humanities & Social Sciences, PUMC

Q& A: 10 minutes

2:45-3:00 PM  Break

Session II  INFORMED CONSENT WEST AND EAST
MODERATOR: PETER ANGELOS, M.D., PH.D.

3:00- 3:45 PM   Surgical Informed Consent Process and Trust

PRESENTER:  J. MICHAEL MILLIS, M.D.
                               
Q & A: 10 minutes

3:45-4:15PM  Informed Consent in China
  
PRESENTER:  ZHAI XIAOMEI, Ph.D

Q & A: 10 minutes

4:15-5:15PM  CASE PRESENTATION
Chair and Moderator: Peter Angelos, M.D., Ph.D.
Case 1: Case of Informed Consent, but different operation needs to be performed
Case 2:  Case of Mentally incapacitated patient and differing opinions from care giver and
medical team

Case 3: Patient who recently experienced a life threatening motor vehicle accident needs surgery to stop bleeding but is refusing surgery. 

Case 4: 70 yr old with chronic lung disease brought to the ER with worsening respiratory failure with an advanced directive indicating he does not want to be intubated and is currently unable to make his own decisions.

SATURDAY, MARCH 18

Session III REPRODUCTIVE ETHICS AND DECISION MAKING IN CLINICAL CONTEXT

MODERATOR: J. MICHAEL MILLIS, M.D.

9:00-9:45AM KEYNOTE ADDRESS II
Cesarean section on maternal request: Did we let concerns for anatomy get ahead of safety?

PRESENTER: PAUL D. BURCHER, M.D., Ph.D.
Program Director of Obstetrics and Gynecology
Associate Professor of Bioethics and OB/Gyn
Associate Director of Alden March Bioethics Institute
Obstetrics and Gynecology
Albany Medical College

Q & A: 10 minutes


9:45-10:30 AM    Ethical Issues in Gynecology and Obstetrics

PRESENTER: LIU XINYAN, MD. Ph.D.
Professor and Chair, Department of Gynecology and Obstetrics,
PUMC Hospital

Q & A: 10 minutes

10:30-10:45AM     BREAK


SESSION IV SURROGATE DECISION MAKING

MODERATOR: BERNARD LO

10:45-11:30AM    Medical Decision Issues in the Care for Elderly Patients

 PRESENTER: KANG LIN, MD
 Associate Professor, Vice-Chair, Department of Geriatrics, PUMC Hospital
 Member & Secretary General, The Society for Geriatrics, Beijing
 Medical Doctor Association

 Q & A: 10 minutes

11:30-12:15PM    The Role of the Surrogate in Surgical Decision Making

 PRESENTER: PETER ANGELOS, M.D., PH.D.

 Q & A: 10 minutes

12:15-1:15 PM    LUNCH AT THE CENTER (For all participants)


Session V  REPRODUCTIVE ETHICS II

MODERATOR: XIAO MEI ZHAI

1:15-2:00PM        Genetic Counseling on genetic testing and post-testing issues
                              
PRESENTER:  HUANG SHANGZHI, M.D.
Head of WHO Collaborating Center for Community Control of Hereditary Diseases
Director of Genetics and Reproductive Committee, Across-strains Association of Medical Exchanges
Professor, Department of Genetics, School of Basic Medicine, PUMC

Q & A: 10 minutes

2:00-2:45PM      Shared Decision Making in Obstetrics and Gynecology

PRESENTER: PAUL D BURCHER M.D., Ph.D.

Q & A: 10 minutes

2:45-3:30PM      Ethical Issues in Artificial Reproductive Technology

PRESENTER:  SUN ZHENGYI, M.D., Ph.D.                      

Professor & Director, Laboratory of Center for Reproduction Department of Gynecology & Obstritics
PUMC Hospital  

Q & A: 10 minutes


3:30-4:15PM      Decision Making in Assisted Reproduction/ IVF in China

PRESENTER: LAI LILI, Ph.D.
Associate Professor of Anthropology
Institute for Medical Humanities
Peking University

Q & A: 10 minutes

4:15-4:30PM  Break

SESSSION VI  DECISION MAKING: CONFLICTS AND THE LAW

MODERATOR: J. MICHAEL MILLIS, M.D.

4:30-5:15PM     Remarks on the Stipulation of Physician’s Professional Responsibility and Informed Consent in China’s Tort Law

PRESENTER: JIA PING, Ph.D.
Adjunct Professor, St. Mary's University School of Law, Texas, USA
Research Fellow, Center for Bioethics
Chinese Academy of Medical Sciences & PUMC

Q & A: 10 minutes   

     
5:15-6:00PM   Conflicts of Interest in Medicine: An International Problem

Presenter:  BERNARD LO, M.D.

Q & A: 10 minutes

会议日程


3月17日 周五


第1部分 会议开幕

主持人:J. Michael Millis, M.D.
芝加哥大学全球外科中心副主任,外科学教授


1:00 – 1:15 PM 欢迎致辞与介绍
共同主持:
翟晓梅, Ph.D.
中国医学科学院/北京协和医学院生命伦理学研究中心执行主任
北京协和医学院人文和社会科学学院院长、教授

Peter Angelos, M.D., Ph.D.
芝加哥大学医学院MacLean临床医学伦理学中心副主任
内分泌外科伦理学主任
Linda Kohler Anderson荣誉外科教授

J. Michael Millis, M.D.


1:15 – 2:00 PM 主题演讲

不同文化下临终时的困难决策
演讲嘉宾: Bernard Lo, M.D.
绿墙基金会主席及CEO
加州大学旧金山分校医学伦理学项目荣誉主席,荣誉医学教授
问答环节:10分钟


2:00 – 2:45 PM 内外科紧急事件下伦理决策的跨文化视角
演讲嘉宾: 邱仁宗,Ph.D.
北京协和医学院人文和社会科学学院教授
中国医学科学院/北京协和医学院生命伦理学中心学术委员会主任
问答环节:10分钟


2:45 – 3:00 PM 茶歇

第2部分 东西方环境下的知情同意

主持人:Peter Angelos, M.D., Ph.D.
3:00 – 3:45 PM 外科知情同意的获取与信任
演讲嘉宾:J. Michael Millis, M.D.
问答环节:10分钟


3:45 - 4:15 PM 中国医疗情境下的知情同意
演讲嘉宾:翟晓梅, Ph.D.
问答环节:10分钟

4:15 – 5:15 PM 病例环节

主持人:Peter Angelos, M.D., Ph.D.
病例1:需要进行不同手术情况下的知情同意
病例2:精神上无行为能力患者遇到医生团队和护理者的意见
冲突
病例3:致命摩托车事故后流血不止需要手术的患者拒绝手术
病例4:70岁慢性肺部疾病患者因出现呼衰加重前往急诊,此前签署拒绝插管协议,但目前处于意识不清无法进行决策的
状态

3月18日 周六

第3部分 临床中的PPR与决策

主持人:J. Michael Millis, M.D.
9:00 – 9:45 AM 主题演讲
产妇要求下的剖腹产:自主决策的考虑能否先于安全性?
演讲嘉宾:Paul Burcher M.D., Ph.D.
美国奥尔巴尼医学院妇产科
美国奥尔巴尼医学院Alden March生命伦理所副所长
生命伦理学及妇产科副教授、妇产科项目主任
问答环节:10分钟


9:45 – 10:30 AM 妇产科的伦理问题
演讲嘉宾: 刘欣燕, MD, Ph.D.
北京协和医院妇产科主任医师、教授

问答环节:10分钟


10:30 – 10:45 AM 茶歇

第4部分  代理决策

主持人:BERNARD LO
10:45 – 11:30 AM 老年患者护理中的医疗决策问题
演讲嘉宾:康琳, M.D.
北京医师协会老年医学分会成员及秘书长
北京协和医院老年医学系副主任及副教授
问答环节:10分钟


11:30 – 12:15 AM 外科决策中的代理决策
演讲嘉宾:Peter Angelos, M.D., Ph.D.
问答环节:10分钟

12:15 – 1:15 PM 午餐 (所有与会者)

第5部分 生育相关伦理 II

主持人:翟晓梅

1:15 - 2:00 PM 基因咨询中的咨询师与咨询者:伦理学视角
演讲嘉宾:黄尚志, M.D.
北京协和医院学院基础医学院遗传学系教授
跨种医学交流协会遗传与生殖协会主任
WHO社区遗传疾病控制合作中心主任
问答环节:10分钟


2:00 – 2:45 PM 妇产科中的参与式决策
演讲嘉宾: Paul Burcher, M.D., Ph.D.
问答环节:10分钟


2:45 – 3:30 PM 辅助生殖技术(ART)中的伦理问题
演讲嘉宾: 孙正怡, M.D., Ph.D.
北京协和医院妇产科生殖中心实验室主任及教授
问答环节:10分钟


3:30 – 4:15 PM 中国环境下的辅助生殖/试管婴儿(IVF)决策
演讲嘉宾:赖立里, Ph.D.
北京大学医学人文研究院人类学副教授
问答环节:10分钟


4:15 – 4:30 PM  茶歇

第6部分  冲突与法律下的医疗决策

4:30 – 5:15 PM 中华人民共和国侵权责任法中医师职业责任与知情同意
条例点评
演讲嘉宾: 贾平, Ph.D.
中国医学科学院 北京协和医学院
美国德克萨斯州圣玛丽学院法学系兼职教授
问答环节:10分钟


5:15 – 6:00 PM 利益冲突:一个国际性的问题
演讲嘉宾: Bernard Lo, M.D.