The Southern California region of Providence Health & Services has entered into a joint agreement with the Bioethics Institute at Loyola Marymount University in Westchester in which the LMU faculty will be available to the Providence hospitals to assist with bioethics education and the Torrance facility will host clinical rounds for the graduate students.
The four regional hospitals are Little Company of Mary, Torrance; Little Company of Mary-San Pedro Hospital; Providence Saint Joseph Medical Center, Burbank; and Providence Holy Cross Medical Center, Mission Hills.
James Walter, PhD, chairperson of LMU's Bioethics Institute, and Glen Komatsu, MD, director of LCM Torrance hospital's Doak Center for Palliative Care, will be in charge of the weekly rounds with the graduate students. The 40 students currently enrolled in the master's program include a diversity of backgrounds --- transplant surgeon, ER doctor, social worker and film student.
"It's a bit of an unusual arrangement," Walter says, "for a university with no allied health science department, nursing school or med school to enter into a partnership with a hospital group. But that's precisely the arrangement that has formed between the two groups in a collaboration designed to support healthcare and education within the Catholic tradition. We're trying to better serve the needs of both the patients and the students. Our intent is not to take over the bioethics committee but to supplement it."
Komatsu is enthusiastic about enhancing the system's ethics program. "We don't ever want to be complacent in our ethics practice," he explains. "An affiliation like this will help us improve in the practice of ethical discourse and discernment. Academic ethicists are rigorous and precise in their thinking. Clinicians need that type of input and influence in our practice. We tend to do what we feel is right but can't always explain why. Bioethics rationale and process are very important even if we ultimately come to the same conclusion. If we use an appropriate decision-making process, the chances of making a sound ethical decision are greater."
LMU offers the only freestanding bioethics program west of the Mississippi; other bioethics programs are part of philosophy or medical divisions. According to Walter, the faculty members have clinical responsibilities or are trained in clinical bioethics, generally working in intensive care units to help bolster bioethics reflection within critical care. Walter joined LMU to establish the Bioethics Institute and had identified Little Company of Mary as a potential partner before it joined Providence Health & Services in 1999.
The process has admittedly been a slow one; the institute was developed seven years ago as an outreach program, and the graduate program is two years old. During that time, however, there have been many changes in healthcare, from the developments in stem cell research, pharmacogenetics and molecular biology to the ever-evolving crisis in healthcare delivery.
As Walter points out, the United States is the only developed country out of 54 that doesn't offer universal healthcare. "Bioethics needs to be center stage in the culture of ethical reflection --- from admissions to clinicians and everyone in between. How will our current students mold and create this environment going forward?"
LMU's Bioethics Institute offers a ten-week survey course in bioethics every fall for healthcare and legal professionals (see http://myweb.lmu.edu/jwalter/survey.htm for more information), including topics such as "the ethical and legal aspects of forgoing/withdrawing medical treatment" and "the ethical and legal aspects of organ and tissue procurement," a course is taught by Walter and adjunct professor Michael Pesce, MD, a staff anesthesiologist at Century City Doctor's Hospital.
"We see this collaborative relationship between LMU and Providence Health & Services as a unique way for both of our Catholic faith-based institutions to further their mission and values and equip our lay leaders for the future," says Dominican Sister Colleen Settles, regional director of mission leadership for Providence Health & Services. "We look forward to other such collaborative ventures between Catholic healthcare and higher education within the Archdiocese of Los Angeles."
Komatsu, whose interest and self-study in ethics led him to pursue a fellowship in palliative care at Harvard University several years ago, appreciates that a formal educational opportunity is now available to him and his colleagues.
"Although Providence has excellent ethicists in the system, such as Jan Heller and John Tuohey, it's wonderful to have a local relationship," Komatsu says. "Dr. Walter will be a resource and mentor for me and the ethics program for second opinions and ethical reflection, which in turn will help the practice of medicine at Little Company of Mary." |