Aasim I. Padela, MD, MSc, FACEP

"Accommodating Differing Values, Norms and Ontologies in Healthcare Delivery: Using Muslims & End-of-Life Healthcare as a Case Example"

Professor and Vice Chair for Research and Scholarship, Department of Emergency Medicine

Professor of Bioethics and Medical Humanities, Institute of Health & Equity

The Medical College of Wisconsin

Healthcare near the end-of-life is complicated by communication and knowledge gaps between patients, clinicians, and families. These gaps also feed into moral uncertainty, and at times moral conflict, among these decision-makers.  When religious beliefs and values are added to the mix, conflicts often intensify, and communication gaps seemingly widen. This presentation will draw upon leading patient-doctor communication models and best practices in clinical ethics consultation to provide a practical ethics framework through which to address such challenges by increasing understanding of the moral valences of actions and decisions.  The three-step approach calls for (i) discovering the meaning and values ascribed to living and death, (ii) considering norms and constraints upon biomedical practices and communities, and (iii) negotiating and accommodating both the actions and non-actions taken by clinicians, individuals, and families. Accordingly, the first step involves examining religious ontologies, the second step religious ethics and healthcare laws and policies, and the third involves deliberative action. Three cases of religious conflict near the end-of-life will illustrate the framework in action and reinforce the merits of the approach.