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National Center for Ethics in Health Care

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Policy and Guidance

NCEHC identifies, analyzes and clarifies standards for practice through the development and interpretation of VHA national policies on ethics in health care, as well as through guidance, related forms and electronic health record tools. NCEHC develops policy, guidance, forms or electronic tools to (1) respond to changes in law, regulation, clinical practice, public health events or Executive Branch priorities that require national VHA standards; (2) respond to system-wide ethics problems or vulnerabilities as directed by VHA leadership; (3) address gaps between system-wide practices and strong ethics standards; (4) ensure coordinated design, development and management of electronic record tools and functionalities to help drive ethical practice; (5) support program offices that seek assistance in developing VHA national policies and guidance with significant ethical implications.

 NCEHC Policy

 NCEHC Guidance

Advance Care Planning and Management of Advance Directives 

Disclosure of Adverse Events to Patients 

Financial Relationships between VHA Health Care Professionals and Industry 

iMedConsent™

Informed Consent for Clinical Treatments and Procedures 

Informed Consent for Long-Term Opioid Therapy for Pain 

IntegratedEthics® 

Life-Sustaining Treatment (LST) Decisions 

National Center for Ethics in Health Care 

State-Authorized Portable Orders

Ethical Issues in Ebola Virus Disease Preparedness and Response 

Ethical Issues in Pandemic Influenza Preparedness and Response 

Improving Informed Consent for HIV Testing 

National Ethics Committee (NEC) Reports 

Protocol for Prioritizing HCV Treatment: An Ethical Framework 

Report of a Work Group on Post Traumatic Stress Disorder (PTSD) and Vulnerable Populations in Research

 

 

NCEHC Policy 

Relevant Materials 

VHA Handbook 1004.02: Advance Care Planning and Management of Advance Directives
(December 24, 2013)

VA Form 10-0137: VA Advance Directive - Durable Power of Attorney for Health Care and Living Will

VA Form 10-0137 - Spanish/English: Directrices Anticipadas De Va Poder Legal Para La Designacion De Agente Para El Cuidado De Salud Y Testamento En Vida

VA Form 10-0137 A: Your Rights Regarding Advance Directives 

VA Form 10-0137 B: What You Should Know About Advance Directives

Mental Health Care Preferences Worksheet - Optional file to attach to your advance directive

Who to Contact in an Emergency Worksheet - Optional file to attach to your advance directive

Model MCM Template for VHA HB 1004.02: Advance Care Planning and Management of Advance Directives

CPRS Advance Directive Notification and Screening (ADNS) Documentation

Training Module and Materials: VHA Training for Staff Who Provide Information and Assistance with Completing Advance Directives

Training Module: Advance Care Planning and Advance Directives, Goals of Care Conversations and Life-Sustaining Treatment Decisions, State-Authorized Portable Orders: How Do These Pieces Fit Together to Elicit and Document Patient Treatment Preferences?

FAQ: Advance Care Planning and Management of Advance Directives

Podcast: Identifying the Patient’s Authorized Surrogate: Close Friends as Surrogate Decision-Makers (6:12)

Podcast: Differences Between Life-Sustaining Treatment Orders and Advance Directives

VHA Handbook 1004.08: Disclosure of Adverse Events to Patients
(October 2, 2012. corrected copy October 12, 2012) 

Training Module: Clinical and Institutional Disclosure of Adverse Events

Training Module: Critical Thinking About Institutional Disclosure of Adverse Events

VHA Handbook 1004.07: Financial Relationships Between VHA Health Care Professionals and Industry
(November 24, 2014)

Training Module for Health Care Professionals

Training Module for Service Chiefs to Present to Professional Staff on Financial Conflicts of Interest - Script

Training Module for Service Chiefs to Present to Professional Staff on Financial Conflicts of Interest - Slides

Model MCM Template for VHA Handbook 1004.07: Financial Relationships Between Health Care Professionals and Industry

Verbal Disclosure Script for Chair

Verbal Disclosure Information for Members

National Ethics Committee Report: Compensation to Health Care Professionals from the Pharmaceutical Industry

National Ethics Committee Report: Gifts to Health Care Professionals from the Pharmaceutical Industry
VHA Handbook 1004.05: iMedConsent™
(December 10, 2014)

FAQ: iMedConsent™ Asynchronous Signature

FAQ: iMedConsent™ DNR Discussion Wizard

Model MCM Template for VHA HB 1004.05, iMedConsent™

VHA Handbook 1004.01: Informed Consent for Clinical Treatments and Procedures 
(August 14, 2009)

FAQ: VHA Notice 2017-38, Amendment of VHA Handbook 1004.01: Removing the Requirement for Specific Documentation of Oral Informed Consent to Tests for Hepatitis B (HBV) Virus and Hepatitis C (HCV) Virus

EthicsRx - Signature Informed Consent Workflows: "Gurney Consent" (July 28, 2015)

Podcast: Obtaining and Documenting Oral Informed Consent for HIV Testing (5:59)

VHA Directive 1005: Informed Consent for Long-Term Opioid Therapy for Pain
(May 6, 2014)

VA Form 10-0431c: Consent for Long-term Opioid Therapy for Pain

Model MCM Template for VHA D 1005: Informed Consent for Long-Term Opioid Therapy for Pain

Safe and Responsible Use of Opioids for Chronic Pain: A Patient Information Guide 

COMING SOON! Spanish - Safe and Responsible Use of Opioids for Chronic Pain: A Patient Information Guide

Podcast: Informed Consent for Long-Term Opioid Therapy for Pain (7:27)

Podcast: Urine Drug Testing in the Context of Long-Term Opioid Therapy for Pain (5:42)

FAQ: VHA Directive 1005, Informed Consent for Long-Term Opioid Therapy for Pain

VHA Handbook 1004.06: IntegratedEthics®
(August 29, 2013)

FAQ: VHA Handbook 1004.06® 

Model MCM Template for VHA Handbook 1004.06: IntegratedEthics®

VHA Handbook 1004.03: Life-Sustaining Treatment (LST) Decisions: Eliciting, Documenting, and Honoring Patients’ Values, Goals, and Preferences
(January 11, 2017)

Model MCM Template for VHA Handbook 1004.03: LST Decisions

Crosswalk of Policy Changes

LSTDI Webpage

VHA Directive 1004: National Center for Ethics in Health Care
(September 6, 2013)
 
VHA Handbook 1004.04: State-Authorized Portable Orders
(October 25, 2012)
Training Module: Advance Care Planning and Advance Directives, Goals of Care Conversations and Life-Sustaining Treatment Decisions, State-Authorized Portable Orders: How Do These Pieces Fit Together to Elicit and Document Patient Treatment Preferences?

 

NCEHC Guidance 

Ethical Issues in Ebola Virus Disease Preparedness and Response
Ethical Issues in Pandemic Influenza Preparedness and Response
Improving Informed Consent for HIV Testing
National Ethics Committee (NEC) Reports
Protocol for Prioritizing HCV Treatment: An Ethical Framework
Report of a Work Group on Post Traumatic Stress Disorder (PTSD) and Vulnerable Populations in Research