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NET Summaries
National Ethics Teleconferences (NET calls) provide education on selected topics in health care ethics and offer an opportunity for practitioners and others throughout VHA to discuss an important health care ethics issue. Summaries of recent NET calls are listed below. Summaries of earlier calls can be found on the Archives page.
To view a list of NET call summaries organized by ethics domain and topic click here.
Ethical Considerations in the use of Home Oxygen for Patients and/or Third Parties Who Smoke (July 30, 2008) [Word] (Audio not available)
Executive Summary and other resources [Word]
Ethics and the Discharge Process: What to Consider When a Patient Prefers a Plan that the Team Believes is Unsafe (May 28, 2008) [Word]
National Ethics Committee Report: Advance Directives for Mental Health: An Ethical Analysis of State Laws & Implications for VHA Policy (March 26, 2008) [Word]
Disclosure of Adverse Events to Patients: Ethical and Policy Requirements (February 26, 2008) [Word]
Strategies for Increasing Influenza Vaccination Rates in Health Care Workers: Ethical Considerations (January 30, 2008) [Word]
National MRSA (Methicillin-Resistant Staphylococcus Aureus) Initiative: Ethical Considerations in Implementation (October 2007) [Word]
National Ethics Committee Report - Impaired Driving in Older Adults: Ethical Challenges for Health Care Professionals (September 2007) [Word]
State-Authorized Portable Orders: Out of Hospital DNR Orders and Orders for Life-Sustaining Treatment (July 2007) [Word]
National Ethics Committee Report: Ethical Aspects of the Relationship between Clinicians & Surrogate Decision Makers (April 2007) [Word]
Advance Care Planning and Management of Advance Directives (March 2007) [Word]
IntegratedEthics Initiative: Ready to Launch (January 2007) [Word]
Informed Consent Practices: Lessons Learned from Implementing iMedConsent (November 2006) [Word]
Adverse Events and the Management of DNR Orders: Ethical Considerations (September 2006) [Word]
National Ethics Committee Report: The Ethics of Palliative Sedation as a Therapy of Last Resort (July 2006) [Word]
Influenza Pandemic Preparedness Planning: Ethics Concerns (June 2006) [Word]
Patients' Requests to Have Their Health Records Amended (May 2006) [Word]
Ethical Considerations of Cardiac Pacemakers and Implantable Defibrillators for End-of-Life Care (April 2006) [Word]
The Ethical Challenges of Coordinating Mental Health Care Between VHA and DoD (March 2006) [Word]
National Ethics Committee Report: Compensation to Health Care Professionals from the Pharmaceutical Industry (February 2006) [Word]
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NET Summaries Table of Contents - (by ethics domain and topic)
Use the links below to find summaries of National Ethics Teleconferences organized by ethics domain and topic.
To view a list of NET call summaries organized chronologically click here.
Shared Decision Making with Patients
Decision-making capacity
Informed consent process
Surrogate decision making
Advance care planning
Limits to patient choice
Other
1.a Decision-making capacity [ability of the patient to make his/her own health care decisions]
Ethics Center content
Ten Myths About Decision-Making Capacity (NET Summary November 2002) [Word]
Source Patient HIV Testing in Patients Who Lack Decision-Making Capacity (NET Summary October 2002) [Word]
Common Pitfalls in Determining Decision-Making Capacity-Live from the National Ethics Committee Meeting (NET Summary March 2001) [Word]
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1.b Informed consent process [providing information to the patient/surrogate, ensuring that the decision is voluntary, documenting the decision]
Ethics Center content
Informed Consent for HIV Testing: Ethical Issues (NET Summary June 2004) [Word]
Informed Consent Policy Revision (NET Summary January and February 2003) [Word]
Informed Consent Policy Revision: Medical Decision Making in Patients Without Surrogates (NET Summary January 2002) [Word]
Informed Consent for IV Contrast Administration (NET Summary January 2001) [Word]
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1.c Surrogate decision making [selection, role, and responsibilities of the person authorized to make health care decisions for the patient]
Ethics Center content
National Ethics Committee Report: Ethical Aspects of the Relationship between Clinicians & Surrogate Decision Makers (NET Summary April 2007) [Word]
Disclosing Patients' Protected Health Information (NET Summary February 2005) [Word]
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1.d Advance care planning [statements made by a patient with decision-making capacity regarding future health care decisions]
Ethics Center content
National Ethics Committee Report: Advance Directives for Mental Health: An Ethical Analysis of State Laws & Implications for VHA Policy (NET Summary March 26, 2008) [Word]
Advance Care Planning and Management of Advance Directives (NET Summary March 2007) [Word]
Strategies to Make Advance Care Planning More Effective: Best Practices (NET Summary March 2003) [Word]
Ethical Issues in Advance Directives for Behavioral Health Care (NET Summary May 2003) [Word]
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1.e Limits to patient choice [e.g., choice of care setting, choice of provider, a demand for unconventional treatment]
Ethics Center content
Ethical Considerations When Treating Erectile Dysfunction in Patients with Sexually Transmissible Diseases (NET Summary May 2004) [Word]
Should Patients be Able to Refuse Care by House Officers or Trainees? (NET Summary March 2004) [Word]
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1.f Other
Ethics Center content
Ethics and the Discharge Process: What to Consider When a Patient Prefers a Plan that the Team Believes is Unsafe (NET Summary May 28, 2008) [Word]
Strategies for Increasing Influenza Vaccination Rates in Health Care Workers: Ethical Considerations (NET Summary January 30, 2008) [Word]
National MRSA (Methicillin-Resistant Staphylococcus Aureus) Initiative: Ethical Considerations in Implementation (NET Summary October 2007) [Word]
National Ethics Committee Report - Impaired Driving in Older Adults: Ethical Challenges for Health Care Professionals (NET Summary September 2007)
Informed Consent Practices: Lessons Learned from Implementing iMedConsent (NET Summary November 2006) [Word]
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Ethical Practices in End-of-Life Care
Cardiopulmonary resuscitation (CPR)
Life-sustaining treatments
Medical futility
Hastening death
Death and postmortem issues
Other
2.a Cardiopulmonary resuscitation (CPR) [withholding/stopping resuscitation in the event of cardiopulmonary arrest, including DNAR orders]
Ethics Center content
Adverse Events and the Management of DNR Orders: Ethical Considerations (NET Summary September 2006) [Word]
What Does DNR Really Mean? (NET Summary June 2005) [Word] DNR FAQs [PDF]
Do Not Resuscitate Policy Revision: Controversial Topics (NET Summary March 2002) [Word]
Family Presence During Resuscitation (NET Summary August 2001) [Word]
DNR Orders and the Electronic Medical Record (NET Summary December 2000) [Word]
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2.b Life-sustaining treatments [withholding or stopping artificially administered fluid or nutrition, mechanical ventilation, dialysis, surgery, antibiotics, etc.]
Ethics Center content
State-Authorized Portable Orders: Out of Hospital DNR Orders and Orders for Life-Sustaining Treatment (NET Summary July 2007) [Word]
Ethical Considerations of Cardiac Pacemakers and Implantable Defibrillators for End-of-Life Care (NET Summary April 2006) [Word]
Terminal Extubation: Ethics Perspectives (NET Summary March 2005) [Word]
Life Sustaining Treatments and Vegetative State: Implications of the March 2004 Papal Allocution for VHA Health Care (NET Summary October 2004) [Word]
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2.c Medical futility [a physician's judgment that a therapy will be of no benefit to a patient and that it should not be offered or should be withdrawn]
Ethics Center content
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2.d Hastening death [intentionally or unintentionally, e.g., questions related to euthanasia, assisted suicide, or the doctrine of double effect]
Ethics Center content
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2.e Death and postmortem issues [determination of death, organ donation, autopsy, disposition of body or tissue, etc.]
Ethics Center content
Practicing Medical Procedures on the Newly Dead (NET Summary November 2003) [Word]
Ethical Priority of Decedent's vs. Family's Wishes in Organ Donation (NET Summary July 2002) [Word]
Privacy Requirements During the Organ Donation Process (NET Summary January 2001) [Word]
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2.f Other
Ethics Center content
Palliative sedation -
National Ethics Committee Report: The Ethics of Palliative Sedation as a Therapy of Last Resort (NET Summary July 2006) [Word]
Terminal Sedation: An Open Discussion (NET Summary August 2002) [Word]
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Patient Privacy and Confidentiality
Privacy
Confidentiality
Other
3.a Privacy [protecting individuals' interests in maintaining personal space free of unwanted intrusions and in controlling data about themselves]
Ethics Center content
Patients' Requests to Have Their Medical Records Amended (NET Summary May 2006) [Word]
The Ethical Challenges of Coordinating Mental Health Care Between VHA and DoD (NET Summary March 2006) [Word]
Privacy, Safety and Patient Social Security Numbers: Ethics Concerns (NET Summary July 2005) [Word]
National Ethics Committee Report, Online Patient-Clinician Messaging: Fundamentals of Ethical Practice (NET Summary September 2004) [Word]
Privacy Requirements During the Organ Donation Process (NET Summary January 2001) [Word]
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3.b Confidentiality [nondisclosure of information obtained as part of professional-patient relationship]
Ethics Center content
The Ethical Challenges of Coordinating Mental Health Care between VHA and DoD (NET Summary March 2006) [Word]
Shared Medical Appointments: Ethical Concerns (NET Summary October 2005) [Word]
The Ethical Duty to Protect Third Parties from Dangerous Patients (NET Summary April 2005) [Word]
Disclosing Patients' Protected Health Information (NET Summary February 2005) [Word]
Informed Consent for HIV Testing: Ethical Issues (NET Summary June 2004) [Word]
Provider Reporting of Impaired or Potentially Impaired Drivers (NET Summary February 2002) [Word]
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3.c Other
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Professionalism in Patient Care
Conflicts of interest
Truth telling
Difficult patients
Cultural/religious sensitivity
Other
4.a Conflicts of interest [situations that may compromise the clinician's fiduciary duty to patients, including inappropriate business or personal relationships]
Ethics Center content
National Ethics Committee Report: Compensation to Health Care Professionals from the Pharmaceutical Industry (NET Summary February 2006) [Word]
National Ethics Committee Report: Ethical Boundaries in the Patient Clinician Relationship (NET Summary September 2003) [Word]
National Ethics Committee Report: Gifts to Health Care Professionals from the Pharmaceutical Industry (NET Summary January 2004) [Word]
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4.b Truth telling [open and honest communication, including disclosing bad news, adverse events]
Ethics Center content
Disclosure of Adverse Events to Patients: Ethical and Policy Requirements (NET Summary February 26, 2008) [Word]
Clinical Use of Placebo: An Ethics Analysis (NET Summary July 2004) [Word]
National Ethics Committee Report: Disclosing Adverse Events to Patients (NET Summary April 2003) [Word]
Notification of Patients Potentially Exposed to Mad Cow Disease Through Prior Blood Transfusion: Testing the Limits of Full Disclosure (NET Summary April 2001) [Word]
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4.c Difficult patients [clinician interactions with patients who are disruptive or who do not adhere to treatment plans/health care recommendations]
Ethics Center content
Ethical Considerations in the use of Home Oxygen for Patients and/or Third Parties Who Smoke (NET Summary July 30, 2008) [Word] ( Audio not available) Executive Summary and other resources [Word]
Ethics and the Discharge Process: What to Consider When a Patient Prefers a Plan that the Team Believes is Unsafe (NET Summary May 28, 2008) [Word]
Ethical Considerations in Opioid Therapy for Chronic Pain Management (NET Summary November 2005) [Word]
The Ethical Duty to Protect Third Parties from Dangerous Patients (NET Summary April 2005) [Word]
Home Oxygen for Patients Who Smoke: Prescription vs. Proscription (NET Summary October 2001) [Word]
Managing 'Difficult' or 'Non-Compliant' Patients: Ethical Challenges (NET Summary September 2001) [Word]
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4.d Cultural/religious sensitivity [clinician interactions with people of different ethnicity, religion, sexual orientation, gender, age, etc.]
Ethics Center content
Cultures and Persons, Patients and Caregivers: Ethical Obligations and Culturally Competent Care (NET Summary August 2003) [Word]
An Ethical Analysis of Ethnic Disparities in Health Care (NET Summary December 2002) [Word]
Conscience -
The Conscience Clause (NET Summary June 2002) [Word]
Duty to Treat -
Influenza Pandemic Preparedness Planning: Ethics Concerns (NET Summary June 2006) [Word]
Health Care Ethics Issues Raised by SARS (NET Summary June 2003) [Word]
Disaster Medicine: Unique Ethical Challenges (NET Summary April 2002) [Word]
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4.e Other
Ethics Center content
Miscellaneous -
Patients' Requests to Have Their Medical Records Amended (NET Summary May 2006) [Word]
National Ethics Committee Report, Online Patient-Clinician Messaging: Fundamentals of Ethical Practice (NET Summary September 2004) [Word]
Pain/suffering -
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Ethical Practices in Resource Allocation
Systems level (macroallocation)
Individual level (microallocation)
Other
5.a Systems level (macroallocation) [how well the facility demonstrates fairness in allocating resources across programs and services]
Ethics Center content
Influenza Pandemic Preparedness Planning: Ethics Concerns (NET Summary June 2006) [Word]
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5.b Individual level (microallocation) [how well the facility demonstrates fairness in allocating resources to individual patients or staff]
Ethics Center content
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5.c Other
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Ethical Practices in Business and Management
Leadership
Human resources
Business integrity
Other
6.a Leadership [behaviors of leaders in support of an ethical environment and culture]
Ethics Center content
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6.b Human resources [supervisory support for an ethical environment and culture through the high performance management system]
Ethics Center content
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6.c Business integrity [practices that support oversight of business practices, compliance with legal and ethical standards, and promotion of business quality and integrity]
Ethics Center content
Copying, Pasting, and Duplicating in the Electronic Medical Record: An Ethical Analysis (NET Summary February 2004) [Word]
The Relationship Between Ethics and Compliance and Business Integrity (NET Summary July 2001) [Word]
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6.d Other
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Ethical Practices in Government Service
Government ethics rules and laws
Other
7.a Government ethics rules and laws [ethics rules, policies or standards of conduct that apply to federal government employees (e.g., bribery, nepotism, gift and travel rules)]
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7.b Other
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Ethical Practices in the Everyday Workplace
Respect and dignity
Ethical climate
Other
8.a Respect and dignity [e.g., employee privacy, personal safety, respect for diversity]
Ethics Center content
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8.b Ethical climate [e.g., openness of ethics discussion, perceived pressure to engage in unethical conduct]
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8.c Other
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Ethical Practices in Research
Informed consent
Other
9.a Informed consent [providing information to the research subject or surrogate, ensuring that the decision is voluntary, and documenting the decision]
Ethics Center content
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9.b Other
Ethics Center content
Genetics/genomics -
The Ethics of Tissue Banking for Future Genetic Research (NET Summary July 2003) [Word]
Quality Improvement -
Recommendations for the Ethical Conduct of Quality Improvement (NET Summary September 2002) [Word]
Miscellaneous-
Access to VA Databases for Research Purposes (NET Summary February 2001) [Word]
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