Continuing Education Objectives

13 units will be available to nurses, and physicians. Social workers will receive 10 units (apologies, NASW is accrediting our 55-minute sessions as 0.75 units, we can’t convince them otherwise). Certificates will be e-mailed within 6 weeks of the conference.

Session: Some Myths about Aid in Dying.
Presenter: Lonny Shavelson, MD
Chair
American Clinicians Academy on Medical Aid in Dying

Learning objectives:

At the completion of this activity, the learner will be able to:

  1. Incorporate into their practices that aid in dying is about caring for patients, not writing prescriptions.
  2. Utilize in their practices the understanding that patients do not come to them requesting aid in dying, but rather considering aid in dying.
  3. Understand that fatigue is a very common but little-discussed reason a patient moves forward with aid in dying.

Session: Hospices and Aid in Dying — A land of many journeys.
Presenter/Moderator: Amy Yoffe, LCSW

Learning Objectives:

  1. At the completion of this activity, the learner will be able to explain the benefits of Hospice to patients considering medical aid in dying, in their clinical practice.
  2. At the completion of this activity, the learner will be able to communicate the wide spectrum of policies and practices among hospice agencies, in their clinical practice.
  3. At the completion of this activity, the learner will be able to identify the interplay of medical and psychosocial needs of medical-aid-in-dying patients on hospice, in their clinical practice.

Session: Prognostic Dilemmas in Aid in Dying
Presenter/Moderator: Dr. Kelly McCann, UCLA

Objectives:

At the completion of this activity:
1) You will be able to determine how an aid-in-dying less than 6-month prognosis is distinct from the less than 6-month prognosis required for enrolling in hospice.
2) You will be able to identify signs and symptoms that portend poor prognosis.
3) You will appreciate that targeted anti-neoplastic agents and immune checkpoint inhibitors (immunotherapy) can make prognosis less predictable by achieving sometimes dramatic responses with low toxicity.

Session: ALS & the Complexities of Neurodegenerative diseases — From prognosis to ingestion
Presenter/Moderator: Kara Bischoff, MD

At the completion of this activity, the learner will be able to:

  1. Describe reasons that some patients with ALS inquire about and pursue Medical Aid in Dying.
  2. Understand particular barriers that patients with ALS can face to accessing Medical Aid in Dying under current U.S. law.
  3. List two routes by which patients with ALS may ingest Medical Aid in Dying if they are not able to swallow.

Session: Clinician Attendance on the Aid-in-Dying Day
Moderator: Chris Fruitrich, Volunteer Systems Coordinator, American Clinicians Academy on Medical Aid in Dying

Learning objectives:

At the completion of this activity, the attendee will:

  1. Understand the importance of having a clinician at the bedside during an aid-in-dying death.
  2. Understand that bedside attendance focuses not only on the patient, but also the family and others at the bedside.
  3. Know that aid-in-dying deaths present a wide variety of problems, complications and impediments.

Session: The Pharmacology of Aid in Dying, and a Red Flags Update
Lonny Shavelson, MD; Carol Parrot, MD.

Objectives:

At the completion of this activity, the learner will:

  1. More effectively use “time to death” as one important indicator of the quality of an aid-in-dying death.
  2. Incorporate understanding of why a “two system protocol” is used for aid-in-dying medications.
  3. Integrate knowledge of gastrointestinal tract function into their aid-in-dying clinical evaluations and treatments.

Session: Ethical Challenges of Aid in Dying: Case discussions by members of the Ethics Consultation Service, American Clinicians Academy on Medical Aid in Dying
Moderator: Jeanne Kerwin, DMH, HEC-C
Consultant in Bioethics and Palliative Care
Former Member, New Jersey State Advisory Council on End-of-Life Care

Learning Objectives:

At the completion of this activity, the learner will be able to:

a. Identify an ethical question/issue in clinical aid-in-dying practice that might be appropriate and may benefit from an ethics consultation.

b. Understand the mission and role of the Ethics Consultation Service within the American Clinicians Academy on Medical Aid in Dying.

c. Understand the process of ethical analysis used by the Ethics Consultation Service through completed ethical evaluations and recommendations.

Session: Race, Religion, and Spiritual Considerations in Aid in Dying
Presenter/Moderator: Terri Laws, PhD

Learning objectives:

At the completion of this activity, the learner will be able to:

1) Identify race, religious, racial, and spiritual considerations which impact African-American patients requests for and use of medical aid and dying.
2) Assess how patients’ experiences of racism and health disparities impact their interest/pursuit and experience of medical aid in dying.
3) Examine how conscious and unconscious bias impacts our interaction with patients of color in our work as aid-in-dying clinicians/teams.

Session: Capacity and Judgment Evaluations for Patients Considering Aid in Dying
Presenter/Moderator: Thomas Strouse, MD

Learning Objectives
At the completion of this activity

  1. the learner will be able to define the 4 basic abilities patients must demonstrate in order to confirm their capacity to make medical decisions.
  2. the learner will know what standardized instruments are available to assist in formal capacity evaluations
  3. the learner will be familiar with examples of impaired judgment due to mental disorders that might compromise a patient’s ability to capably consent to medical aid in dying

Session: Nursing Care: Evaluating, informing, following, attending
Presenter/Moderator: Thalia DeWolf, RN, CHPN

  1. At the completion of this activity, the learner will be able to identify patient inquiries about medical aid in dying, and offer accurate, relevant information about it.
  2. At the completion of this activity, the learner will be able to identify critical patient assessments and communicate them effectively to the clinical team to help prevent complications from an aid-in-dying procedure.
  3. At the completion of this activity, the learner will be able to integrate the presented materials and effectively prepare patients and their families for a medically assisted death.

Session: Grief Support after Medical Aid in Dying
Sally Thomae, MSW

Learning Objectives:

At the completion of this activity, the learner:

  1. Will be able to apply strategies for organization of bereavement groups within their own practice.
  2. Will distinguish between two types of bereavement groups, and the advantages of each.
  3. Will understand disenfranchised grief and how it is unique in the medical aid in dying process.

Session: Socially challenging settings and circumstances
Moderator: Ellen Wiebe MD
Clinical Professor, University of British Columbia

Learning objectives:
At the completion of this activity, the learner will be able to:

  1. integrate new tools when negotiating with skilled nursing facilities to provide assisted dying in place
  2. demonstrate knowledge of barriers to end of life care including assisted dying to people marginalized by poverty, substance use and mental illness
  3. utilize new strategies to find the best location for assisted dying when home is not available or feasible

Session: Medically-Challenging Cases: Complex gut function; Self-administration by oral, rectal, PEG and ostomy routes.
Presenter/Moderator: Lonny Shavelson, MD; Thalia DeWolf, RN, CHPN

Learning Objectives:

At the completion of this activity, the clinician will be able to:

  1. Improve care of aid-in-dying patients who have complex bowel disorders.
  2. Integrate complex bowel evaluations into their aid-in-dying evaluations.
  3. Apply patient disease information to decisions about which route of administration is appropriate for aid-in-dying medication self-administration.