THE BARANZANO SOCIETY

MEDIA ADVISORY *for immediate release*	Contact	Thomas Dailey, OSFS
	Voice	610.282.1100 ext. 1464
	Fax	610.282.1509
	Email	Thomas.Dailey@desales.edu
	Web	www4.desales.edu/SCFC/Baranzano/home.htm

CENTER VALLEY, PA (January 26, 2004) -- Despite the winter weather advisory, over 100 people gathered in the Labuda Center for the Performing Arts on the campus of DeSales University to participate in a public forum on issues related to patient autonomy at the end of life. The forum, entitled "Managing Our Mortality," was sponsored by The Baranzano Society, a regional group of university scholars, corporate professionals, and healthcare providers who dialogue about bioethical concerns.

Dr. Brian Kane, associate professor of Theology at DeSales University, introduced the topic and moderated the discussion.

Joseph Vincent, MD; Gretchen Fitzgerald, MSN; Brian Kane, Ph.D.; Ronnie Hess, Esq.; Minh Nguyen, M.D. (photo by Brian Werth)

Dr. Joseph Vincent, director of the palliative care program at Lehigh Valley Hospital, opened with comments on the process of dying in the contemporary world. He noted that Roman Catholic theology was responsible for calling attention to the ethical distinction between ordinary and extraordinary means in terms of how to treat dying patients. He raised questions about how people understand the dying process, whether treatment only prolonged dying, and who is responsible for making decisions about a patient's care.

Gretchen Fitzgerald, a nurse practitioner and hospice worker with Lehigh Valley Hospital, followed with comments on how our society has become "death-denying" in an age when death happens more often in hospitals than at home and in a society in which family members are more widely dispersed. Admitting that doctors and nurses may have agendas that differ from those of patients, she emphasized that early communication about a patient's wants and desires is the key to healthcare at the end of life.

Ronnie Hess, a partner in the firm of Tallman, Hudders & Sorrentino who specializes in healthcare law, provided a legal perspective. Comparing Pennsylvania law to the controversy in Florida surrounding the legislature, the governor, and the family of Terri Schiavo, she pointed out that a patient's oral communications are not legally sufficient. In the best cases, the patient makes his/her own decisions about end of life treatment ahead of time and does so in writing, so that no one questions our desires when the time comes.

Finally, Dr. Minh Nguyen, a cardiac surgeon with St. Luke's Hospital, related his own experiences in dealing with patients in end-stage critical care. Early on in his career, he sought to counsel a patient not to take extraordinary means to prolong a painful life; yet the patient, who had survived three major surgeries and lived with continual oxygenation, lived for five more years. Dr. Nguyen concluded by noting that only the patient, not other family members, is in a position to make the best decisions.

Discussion followed among the panelists, who debated questions pertaining to what a "good death" is and who determines what "quality of life" means. The experts agreed that legal concerns about substituted judgment (living wills, advance directives) differ from ethical concerns about living well while dying.

Audience members also participated in the discussion. Comments focused on the lessened interaction of patients with physicians, the conflicts that arise when family members have to make decisions about their loved one's care, and the ethical and cultural dilemmas brought on by a patient's wanting to die.

The experienced doctors wisely concluded the event with two important maxims for healthcare at the end of life. Dr. Nguyen shared a dictum learned in his experience, namely, that healthcare providers should always help, but not at all costs. And Dr. Vincent reminded the audience, many of whom were students in the health professions, that care and treatment are distinct; even where medical treatments are no longer prescribed, one must always care for a patient.