This is the first edition of Coffee with Katarina, a discussion with Katarina Lee-Ameduri, Clinical Ethicist for St. Boniface Hospital and the Catholic Health Corporation of Manitoba as well as an Assistant Professor in the Department of Family Medicine at the University of Manitoba.
Every other month, she’ll provide thoughts on some of the topics she encounters in her day to day work. This month, we’ll learn about Katarina and her role. Going forward, we want to hear the hot topics that come up in your work. Send us a topic that you want discussed in this column at email@example.com
How were you drawn to ethics? What brought you here?
I can say that I’ve been interested in ethics almost my whole life. My parents are both lawyers from a small town in Manitoba, my mom was involved with ethics in our regional health authority. At the same time, when I was quite young, my grandma got sick and spent 19 months in the hospital. In those 19 months, there were many discussions surrounding life sustaining treatments and a lot of difficult, ethical conversations. That experience really started to frame my view on ethics and drew me in.
I can see how that
would have a profound effect on you. In your time here so far, what’s the
number one question that you are asked?
I am often asked about surrogate decision makers.
What is a surrogate
Determining a legally designated medical decision maker varies by province and country. In Manitoba, it’s a bit odd; most people think, my spouse or a family member is my decision maker by default. Often your spouse or adult child is an appropriate person, but without a health care proxy, they are not a legally designated medical decision maker in Manitoba.
What is your
favourite question to answer?
I like when two parties need a bit of mediation to come to a decision, they might both have the same outcome in mind, but are looking at it from different angles. It’s nice to be able to come to a resolution, but that’s not always possible in ethics.
When it comes to preventative ethics, my favourite tool to promote is a health care proxy. There is no harm in completing one, you can change it as many times as you like and it protects you in so many ways. It’s a simple document naming your substitute decision maker, for medical decisions, it makes everything easier.
What is a topic that
isn’t as easy to resolve?
In many organizations, there are sometimes complicated questions when it comes to choice making and freedom. For example, when we’re discussing sexual relationships- there needs to be consent, but how do we know if a person has the ability or capacity to consent? How do we establish that? Who ought to determine this? Policies don’t always solve these issues, and we all have the right to make bad decisions, but the line between respecting bad decisions and protecting the person that we are caring for is hard to balance. It’s tricky.
A word that aligns all
of our organizations, as part of CHCM, is compassion. How does compassion fit
with ethics? Or does it?
I would say, the most compassionate response is often, also, the most ethical response. The expression do no harm only goes so far. Compassion can really help social services and health care providers align themselves with ethical decisions. When we experience compassion fatigue, or empathy fatigue, ethical guidelines can often help bring us to a compassionate response.
Where can people learn
more about ethics?
We have an ethics in film series that’s been really interesting. We watch a Hollywood movie that poses an ethical dilemma and then discuss it.
We recently watched the movie Awakenings with Robert DeNiro and Robin Williams. It’s a movie about a patient who is in a “locked” state, and when he’s prescribed a trial drug, all of his symptoms disappear for a short while. We had a good discussion about care provider relationships with the people we support, the use of pharmaceuticals for the purpose of treatment or research and the ethical debates surrounding them. We have one coming up in February. The Upside starring Kevin Hart and Bryan Cranston- All are welcome to this event!
We’ll also be hosting many different speaker series throughout the year- we’ll be having a town hall on substance use coming up. You can find the events in the Luminescence e-newsletter and on the CHCM website.
Now, this is called
Coffee with Katarina- you’ve lived in many places- which city has the best
coffee and what’s your coffee order?
Vast majority of time I am a black coffee person (I am rarely without coffee in my hand), when being fancy I like an extra hot skim milk latte.
New York has the best coffee, but Houston is a really close second.