Ethics Notes - Post Midterm.docx

Lecture 5 ========= Learning objections 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. Should include similarities between the psychiatric/long term care system and the carceral system, links and economic implications on ethics and human rights. + role of nurse in su...

Lecture 5 ========= Learning objections 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. Should include similarities between the psychiatric/long term care system and the carceral system, links and economic implications on ethics and human rights. + role of nurse in such a system Readings ======== Confinement: A Quick Guide -- MUHC (can put disclaimer that document is not gender inclusive) --------------------------------------------------------------------------------------------- **What does confinement implicate?** - - **[PREVENTATIVE CONFINEMENT (Garde préventive)]** - - - **[PROVISIONAL CONFINEMENT (Garde provisoire)]** - - - - **[REGULAR CONFINEMENT (Garde en établissement)]** - - - **Nursing implications:** - - - - - - - - - - **[MANAGING CONFINEMNT DOCUMENTS]** **First psychiatric evaluation (PSY1):** - - **Second psychiatric evaluation (PSY 2):** - **Delivering white copies of both psychiatric evaluation (PSY1 & PSY2)** - - **[LEGAL PROCEEDINGS]** **Patient receives court documents** - - **Contesting** - - Nursing implications: - - - - - - - - - - - - - **[PRESENTING AT THE COURT HEARING:]** Within the 48 hours prior to the court hearing date **Nursing implications:** Nursing is responsible for organising the transportation if patient is contesting the confinement. Plus, provide patient appropriate medical support as needed (ex. Wheel chair, PRN medication) - - - - - - - - When patient is appearing in court, must return back to the hospital after the court hearing regardless of obtaining a judgment of confinement or not. **Court documents:** - - - - **[PSYCHIATRIC REEVALUATION FOR THE 21 ST DAY:]** (Same as initial Confinement) - - - **[RENEWAL OF CONFINEMENT FOR AN EXTENTION OF 90 DAYS WHEN NECESSARY;]** - - **[CONFINEMENT MAY BE LIFTED]** by a psychiatrist & psychiatric evaluation (PSY) form is filled - - **Nursing implications for Psychiatric Reevaluation resulting in Renewal or Lifting of Confinement** - - - - **[DOCUMENTATION IN PATIENT'S CHART]** The following information is required to be entered or filed in the patient's chart record: - - - - - - **Nursing documentation:** In the progress notes and PTI the following information is included - - - - **[ROLES]** **CLERK / UNIT CORDINATORS** - - - - - **NURSE** - - - - - - - - - - - - - - **ANM / NM** - - - - - - - Summary of Confinement Order Proceedings ---------------------------------------- A close-up of a document Description automatically generated Lecture 5: Lecture Notes ======================== Authorization for Treatment --------------------------- ### Recap of Court Orders Under CCQ - - - - ### Treatment Order - 1. 2. - Confinement in an Institution ----------------------------- ### General Principles - - - - - - ### Parameters - - - - - - ### Types of Confinement - - - - - - - - - - - - - - 1. 2. - - #### Preventative Confinement - - - - - - 1. 2. - - - - - - - - - - - - - - #### Motion for Authorized Confinement -- Process - - - - - - - - #### Motion for Authorized Confinement -- Duration - - - #### Motion for Authorized Confinement -- PSY content - #### Motion for Authorized Confinement -- Court Order Criteria - - - - #### Motion for Authorized Confinement -- Renewal - - - - - #### Motion for Authorized Confinement -- End of Confinement - - - - - 1. 2. - - - - - #### Motion for Authorized Confinement -- Longer Confinement - #### Motion for Authorized Confinement -- Rights Under Confinement - - - - - - - - - - ### Potential Issues in Confinement - - - ### Covid-19 Testing and Confinement - - Caselaw ------- Mention about Joyce Echequan: guest lecturer mentioned forced sterilization and potential lecturer on subject of systemic discrimination - important to make those most oppressed center of discussion, not necessarily through guest lecturing as that is emotionally heavy, but through the contant given. ### Charles Le Moyne c. E.(F.) (CQ) - - - - - - - - - ### CSSS Côte-de-Gaspé c. P(C)-EYB 2013-227952(CQ) - - - - - - - - - ### Hôpital Maisonneuve-Rosement c. H.(M.)-EYP 2013-219305 - - - - - - - - - - - ### J.M. c. Hôpital Jean-Talon du CIUSSS du Nord-de-l'île-de-Montreal, 2018 QCCA 378 - - - - - - - - - - - - - - - - - - - - Privacy: Patient Access and Medical Records ------------------------------------------- ### General - - - - - - - - - - - - ### Deceased Patients - - - - - Privacy, Confidentiality, and Care Issues Regarding Minors ---------------------------------------------------------- - 1. 2. 3. - - - 1. 2. Prof mentioned that blackened or missing pages, unreasoned refusal to give records not acceptable-\> can talk about how McGill, MUHC is doing that right now with the Mohawk Mothers. real world examples help with applicability and awareness. information is in public court documents and news articles - - - - - - - - - - - - - Management of Limited Resources and Patient Rights -------------------------------------------------- - - ### Key Provisions - - - ### Jasmin c Cité de la santé de Laval (AZ-90021046 (CS)) - - - - - - - - - ### Noël-Voizard c. CSSS Lasalle et du Vieux-Lachine (2007 QCCQ 5118) - - - - - - - - - - - - - ### J.O. vs. Hôpital Royal Victoria (2011 QCCS 5532) - - - - - - - - - - - - - - - - - Class 6: \[Midterm\] Childhood Ethics -- Readings ================================================= Reading 1: Breathe, baby, breathe! (132-136 -- Pepperoni Pizza and Sex) ----------------------------------------------------------------------- - - - - - Reading 2: Listening Authentically to Young People's Voices: A Conception of the Moral Agency of Children --------------------------------------------------------------------------------------------------------- - - - - - - - - - - - - - - - - - - - - - Video 1: Glenda Sandy on Jordan's Principle ------------------------------------------- - - Video 2: Jordan's Principle --------------------------- - - - - - - Infographic 1: Jordan's Principle ---------------------------------  ------------------------------------------------------------------------------- Class 6: \[Midterm\] Childhood Ethics -- Lecture (Slides) - - Nursing Children and Families: Ethical Challenges ------------------------------------------------- - - - - - - ### Pediatric Ethical Norms in Canada - - - ### Canadian Pediatric Society Position Statement (2018) - - - - - - - - - ### Which criteria should determine whether therapies should be provided? - - ### Who should decide which tx is best? - - - - ### What about the voice of the child? #### Consent - #### Capacity - - - - #### Health Care Consent Act (Ontario) **Best interests** \(2) In deciding what the incapable person's best interests are, the person who gives/refuses consent on their behalf shall consider: - - - - - - - - - - - - - - - - - - - ### What about Confidentiality? - - - - - - - 1. 2. 3. - ### Special Consideration: Newborns - - - ### What about Long-Term Disability? - - - ### What about Critical Illness? - - - - ### What about Inequities? - - - - - - - - - - ### Pediatric Palliative Care - - - - - - - 1. 2. 3. 4. - - - - - - - - - - - Listening to Children's Voices ------------------------------ - - - - - Strategies for reconciliation: - - - - - - - - - - Class 7: End-of-Life Ethics -- Readings Reading 1: What would it take to die well? A systematic review of systematic reviews on the conditions for a good death, Zaman et al 2021 ----------------------------------------------------------------------------------------------------------------------------------------- - - - 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. - Reading 2: Canadian Palliative Care Nursing Association Position Statement on Medical Assistance in Dying and Nursing Care -------------------------------------------------------------------------------------------------------------------------- - - - - - - - - - - Video 1: Glenda Sandy - Indigenous Reflections ---------------------------------------------- - - - - - - Resource 1: Reflection for HCW on MAiD -------------------------------------- Step 1: Review phases of a process that might lead to medical assistance in dying 1. a. 2. b. 3. c. d. e. 4. f. 5. g. h. i. Step 2: review the value statements and check each that resonates with your perspective - Step 3: determine which of the general views most aligns with your selected value statements at this time - - - - - - Step 4: consider the practical implications of your perspective for your involvement with medical assistance in dying - - Resource 2: End-of-Life Law Timeline ------------------------------------ - - - - - - - - - - - - Class 7: End-of-Life Ethics -- Lecture Good death reflection (article) ------------------------------- - - - - - - - - - - - - - Challenges ---------- - - - - - \*\* women spend 2.5x time on unpaid caregiving than men. Unpaid caregiving tends to be undervalued \*\* how can we better support caregivers? (important to enforce that above challenges are all maintained by underlying drivers of oppression and role we must all play to dismantle them. feeling of burden is learned, not inherent to being a human) - this also does not come discussion, there are expert recommendations already made. we can discuss how we will uphold these recommendations and the challenges we will face doing so. - - - - - - - - - - Applied Ethics and Nursing at the End of Life --------------------------------------------- - - - - - - - - - - - - - - ### The Case of Elena Elena is a 79-year-old woman with an inoperable glioblastoma located in the brainstem. She has a very poor prognosis, and her treating team recommends palliative care. She lacks capacity to participate in healthcare decisions. Lorenzo, Elena's husband insists that she requires active (curative) treatment and ICU care. ICU was consulted but is unanimous that Elena is at the end-of-life and has a very short time to live. They believe that a treatment plan that promotes her comfort and quality of life over prolonging her life is in her best interest. The family disagrees. They strongly feel that they must advocate for Elena to receive all care because according to Lorenzo, she would be willing to undergo pain and suffering in order to keep living. As the nurse taking care of Elena, you receive report that her respiratory status has decompensated. You also hear her moaning, gasping for breath and grimacing as if appearing to be in pain.  - - - - - - - - - - - There is a disagreement about what will benefit her, what is in her best interest, and what is considered inappropriate care - - - How Did We Get Here? -------------------- - - - - - - - - - ### The Discussion Has Shifted A diagram of a different way Description automatically generated with medium confidence - - - ### We know that... - - - - - - - Civil Code of Quebec (add disclaimer for absence of gender neutral terms in excerpts on slide) - - - ### Care Occurs on a Spectrum  ### The Multiple Meanings of Futility A comparison of a comparison between a couple of words Description automatically generated with medium confidence "poor quality of life" is an inaccurate descriptor. its "different QoL that is unacceptable to treating team"  - - - Hassan Rasouli Case ------------------- - - - - - - - - - Applied Ethics: Process in the Event of Disagreement ---------------------------------------------------- - - - - - - - ### Unhelpful Strategies - - - - - - - - - - - ### Helpful Strategies - - - - - - - - - - Act Respecting End of Life Care ------------------------------- - 1. 2. 3. 4. - - - - ### Palliative Care - - - - ### Palliative Sedation (Continuous) - - - - - #### The Case of Donald Donald, a patient with terminal pancreatic cancer has shifted the goals of care to prioritize comfort. He has been admitted to try to get his pain under control. He is in significant pain tonight, despite his regular morphine. The nurse initiates the palliative care orders. He provides a dose of morphine and returns 30 minutes late to re-evaluate. Donald is still in pain. The nurse gives a second dose. He seems much more comfortable and falls asleep. When the nurse checks on Donald a short time later, he has passed away. **Has the nurse done something wrong?** - - - #### Doctrine of Double Effect A white rectangular box with black text Description automatically generated ### Medical Aid in Dying (MAID) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - #### Conscientious Objection as a Nurse treating pt who wants MAiD - - - - - ### Advance Medical Directives (AMD) - - - - - - - - - 1. 2. 3. - - - - - - - - - - - - - -  - - - - - - - - - - - - Workshop 2 (Class 8): Readings ============================== Podcast 1: Hard Call Ep 3 ------------------------- - - - - - - - - - - - - - - - - - - - - - - - - Reading 1: Alberta Health Services MAID Self-Assessment Tool ------------------------------------------------------------ A step by step diagram Description automatically generated ### Step 1: Phases  ### Step 2: Values A brown and white checklist with red text Description automatically generated  ### Step 3: Perspectives A screenshot of a computer Description automatically generated  ### Step 4: Implications A screenshot of a medical assistance Description automatically generated Diagram 1: Storch Model ----------------------- 1. a. b. c. d. 2. e. i. ii. iii. f. iv. v. g. vi. vii. viii. h. ix. x. xi. xii. 3.  Post-Workshop Video on Consent/Self-Determination ------------------------------------------------- - - - - - - - - - - - - - - - - - - a. i. b. c. Class 9: Mental Health Ethics -- Readings ========================================= There are revolutionary, intersection, disability advocates who question the entire system and equate it to the carceral system. This needs to be central to this discussion Learning Objectives - - - - - Content - - - - - Reading 1: Mitchell -- Ethics and Mental Health Nursing ------------------------------------------------------- - - - ### Summary - - - - - ### Ethical Concepts Relevant to Mental Health Nursing - - - - - ### Deeper Views of Autonomy - - ### Paternalism, Coercion, and Power - - - - - - - - - ### Dignity - - - - - - ### Contrasting Consequentialist and Deontological Ethics - - ### Being a Good Nurse #### Wisdom and Courage - - 1. 2. - #### Compassion and the Ethics of Care - - #### Mentors - #### Evaluating the Role of Virtue Ethics - Reading 2: Trauma- and Violence-Informed Care (TVIC) ---------------------------------------------------- - - - - - - - - - - - - - - - - - - - - 1. a. b. c. d. e. 2. f. g. h. i. j. k. l. 3. m. n. o. p. 4. q. r. s. t. - - - Case Study TVIC - - - - - - EQUIP - - - TVIC can be centered in most of the course instead of utilitarianism, deontology, bioethics Class 9: Mental Health Ethics -- Lecture ======================================== Examples to Build Ethical Practice in MH Nursing (Marjorie Montreuil) --------------------------------------------------------------------- Information sharing in child and adolescent MH - - - - - coercion in proving Tx (really common - this is really concerning and underlying issues need to be discussed and addressed) - - - - - - - how to build ethical practice - - - - - - - - - - Class Lecture ------------- Context in Canada ----------------- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - A graph of mental health Description automatically generated - - - - - ### Mental Illness and Violence - - - Diagnostic and Statistical Manual - 5 (DSM5) late 19th - - - - - - - - ### Mental Illness and the Law - - - - - - - - - - - - - - - - - - - - - - - - - Ethics in Mental Health Nursing ------------------------------- - - - - - - - Paternalism, Coercion, and Power in Mental Health ------------------------------------------------- - - - - - - - - - -  - - - - - - Stigma ------ - 1. 2. 3. 4. ### Nursing and Healthcare - - - - - - - - Trauma and Violence Informed Care --------------------------------- - A diagram of different types of health care Description automatically generated - - - - - - -  - A blue and green rectangular box with white text Description automatically generated with medium confidence  Online Module: Artificial Intelligence and Health ================================================= Learning Objectives ------------------- - - - - What is AI? ----------- - - - - - - - - Potentials of AI in Health and Education ---------------------------------------- - - - - - - - - - - - - - - - - - - - AI Ethics in Health (history has to be before content) ------------------------------------------------------ - - - - - - - - - - - - - - - - -  - - - AI and Teaching + Learning (how can we make learning for learning and why is it not so at the moment) ----------------------------------------------------------------------------------------------------- - - - - - - - - Midterm Review Session ====================== - - - - - - - - - - - - - - - Class 10: Public Health Ethics -- Readings ========================================== Reading 1: Upshur, R -- Principles for the justification of public health intervention (2002) --------------------------------------------------------------------------------------------- - **Guiding Questions** - - - - - - - - - - - - - - - - - - - - - - - - **Notes** - - - - - - - - - - - Reading 2: CNA Nurses Ethical Considerations Pandemic ----------------------------------------------------- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Reading 3: Addressing power asymmetries in Global Health: imperatives in the wake of Covid (Abimbola, 2021) ----------------------------------------------------------------------------------------------------------- Summary - - - - - - - - - - - - - - - Video 1: How can public health reduce inequities faced by Indigenous Peoples? ----------------------------------------------------------------------------- - - - - - - - - Video 2: Glenda Sandy, Indigenous Perspectives ---------------------------------------------- **Guiding Questions** - - - - - - - - - - - - - - - - - - **Notes** - - - - Video 3: Sir Michael Marmot on SDH 17:50-19:30 ---------------------------------------------- - - - - - - - - - - Video 4: What is Health Equity ------------------------------ - - 1. 2. - - - - - - - Class 10: Public Health Ethics -- Lecture ========================================= BIPOC Nurses + Midwives ----------------------- still comes off as tokenistic. more than 5 groups on one slide to add "diversity" for 5 minutes. - - - - - - - - - - - - - - Public Health Ethics -------------------- A diagram of a health care ethics Description automatically generated - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -  - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Public Health in Practice ------------------------- ### Rabies - - - - - - - - - - - - - - - ### Obesity Worldwide - - - - - A diagram of a company Description automatically generated with medium confidence - - - - - - - Public Health Values and Law ---------------------------- - - - - - - - - - - - - - - - - - - - - - - - - Public Health Law ----------------- - - - - - - - - - - - - - - - - - - - - - - - - - - - - Slido -----  Ans: Municipal Ans: Federal Ans: all 4 Ans: collaboration Ans: F 🡪 can be organizational, environmental as well, not just relational  Ans: Justin, Felicia's father... Ans: dying experience and pre-existing influential factors that could shape the experience Public Health Ethics -------------------- - A diagram of a diagram of ethics Description automatically generated - - - - - - - - - - - - - - - -  - ### Other Ethical Frameworks for Public Health - 1. a. 2. b. 3. c. 4. d. 5. e. - ### Relationships in Public Health - - - - - - - - Applying Public Health Ethics to Public Health Cases ---------------------------------------------------- ### Tuberculosis A close-up of a poster Description automatically generated - - - - - - - - - - ### Vaccination - - - - - - ### Climate and Health  - - - - - - - - - - - - - - - - A diagram of a health function Description automatically generated with medium confidence  A close-up of several words Description automatically generated Class 11: Harm Reduction, Emergency, and Pandemic Ethics - Readings =================================================================== Article 1: Nurse's Ethical Considerations During a Pandemic ----------------------------------------------------------- **Guiding Questions** 1. 2. *Note: Public Health Principles, refresher*  a. i. ii. b. iii. iv. c. v. vi. d. vii. viii. e. ix. **Notes** - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Article 2: Addressing power asymmetries in global health -------------------------------------------------------- - A screenshot of a computer Description automatically generated - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Global Health Primer -------------------- ### Video 1: Convocation Address Spring 2021, Prof Madhukar Pai - - - - - - - ### Video 2: Dr. Senait Fisseha - Power, Privilege, and Reproductive Justice in Global Health - ### Video 3: GH - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Class 11: Harm Reduction, Emergency, and Pandemic Ethics - Lecture ================================================================== Disaster and Pandemic Preparedness & Response ============================================= Emergency Preparedness/Disaster Planning -------------------------------------------------------------- - - - - - A screenshot of a website Description automatically generated \^ICN Examples of Each Disaster Phase Aligned with the Nursing Process +-----------+-----------+-----------+-----------+-----------+-----------+ | **Disaste | **Definit | **Assessm | **Plannin | **Impleme | **Evaluat | | r | ion** | ent** | g** | ntation** | ion** | | Cycle** | | | | | | +===========+===========+===========+===========+===========+===========+ | **Prepare | Incl | Assess | Develop a | Conduct | Evaluate | | dness** | preventio | region | care plan | training | the | | | n, | for | to | r/t care | training | | | protectio | populatio | address | of | r/t care | | | n, | ns | access | individua | of | | | mitigatio | at risk | and | ls, | populatio | | | n | and | functiona | families, | ns | | | | functiona | l | communiti | w/access | | | "The | l | needs of | es | + | | | capabilit | needs | populatio | during | functiona | | | ies | during | ns | disasters | l | | | necessary | times of | during | ; | needs in | | | to avoid | disaster | times of | focus on | disasters | | | and/or | | disaster | populatio | , | | | prevent a | Conduct a | | ns | IDing | | | disaster, | hazard | Complete | with | gaps and | | | as well | vulnerabi | this | access + | remaining | | | as to | lity | assurance | functiona | needs | | | reduce | assessmen | function | l | | | | the loss | t | in | needs in | Evaluate | | | of life | for | collabora | an | operation | | | and | threats | tion | identifie | al | | | property | and | with | d | plans for | | | by | hazards | stakehold | region | preparedn | | | lessening | that pose | ers | | ess, | | | the | the | to | | response, | | | impact of | greatest | address | | and | | | disasters | risk | needs | | recovery | | | " | | such as | | for | | | | | shelterin | | populatio | | | | | g | | ns | | | | | in place, | | with | | | | | evacuatio | | access + | | | | | n, | | functiona | | | | | and mass | | l | | | | | casualty | | needs | | | | | surge | | | | | | | capabilit | | | | | | | ies | | | +-----------+-----------+-----------+-----------+-----------+-----------+ | **Respons | | | Collabora | ID and | Participa | | e** | | | te | place | te | | | | | w/respons | PHNs and | in | | | | | e | other | ongoing | | | | | partners | support | response | | | | | to | personnel | planning | | | | | develop | to | during | | | | | plans for | provide | the | | | | | triage | care | incident | | | | | algorithm | according | | | | | | s | to the | Participa | | | | | that | developed | te | | | | | determine | algorithm | in | | | | | appropria | s | service | | | | | te | | planning | | | | | care and | Ensure | and | | | | | sustenanc | that | provide | | | | | e | logistics | real-time | | | | | logistics | are in | adjustmen | | | | | for | place to | t | | | | | populatio | support | on the | | | | | ns, | community | basis of | | | | | based on | care | real-time | | | | | their | during | public | | | | | symptoms | the | health | | | | | and | crisis | response | | | | | co-morbid | period | evaluatio | | | | | condition | | n | | | | | s | Conduct | | | | | | | ongoing | Ensure | | | | | | rapid | needed | | | | | | needs | and | | | | | | assessmen | necessary | | | | | | ts | public | | | | | | during | health | | | | | | the | nursing | | | | | | response | care | | | | | | phase in | | | | | | | order to | | | | | | | meet | | | | | | | populatio | | | | | | | n | | | | | | | needs | | +-----------+-----------+-----------+-----------+-----------+-----------+ | **Recover | | | Work | Participa | Conduct | | y** | | | w/communi | te | evaluatio | | | | | ty | in the | n | | | | | stakehold | reconstit | of the | | | | | ers | ution | long-term | | | | | to plan | of | impact of | | | | | for any | critical | disaster | | | | | long-term | services | consequen | | | | | health | and the | ces | | | | | concerns | sustainme | on the | | | | | following | nt | whole | | | | | an | of the | community | | | | | incident, | health | , | | | | | getting | and | promoting | | | | | ahead of | social | public | | | | | the curve | infrastru | health | | | | | by | cture | essential | | | | | identifyi | | services | | | | | ng | Assist | through | | | | | key | the | public | | | | | resources | community | health | | | | | and | to find | nursing | | | | | critical | its new | | | | | | care | normal | | | | | | logistics | post-disa | | | | | | | ster | | +-----------+-----------+-----------+-----------+-----------+-----------+ Major Ethical Issues in Pandemic Planning ----------------------------------------- - - - -  Allocation of Resources in Humanitarian Crisis priority Grou N umber Emergency/lmmediate Urgent Delayed Expectant CO 10 r Yell OW Gree Blue Description Patients Who have life-threatening injuries that are treatable with a minimum amount of time, personnel, and supplies. These patients also have a good Chance Of recove Indicates that treatment may be delayed for a limited period of time without significant mortality or in the ICU setting patients for whom life support may or may not change their outcome given the severity of their illness. Patients with minor injuries whose treatment may be delayed until the patients in the other categories have been dealt with or patients who do not require ICU admission for the rovision Of life Su port, patients Who have injuries requiring extensive treatment that exceeds the medical resources available in the Situation or for Whom life Su port is considered futile. Patients Who are in cardiac arrest and for Which resuscitation efforts are not to be rovided. Christian, M. D. (2019). Triage. Critical care clinics, 35(4), 575-589. - - 1. 2. 3. 4. 5.  A screenshot of a computer Description automatically generated - - - - - - - Professional Responsibilities in Disaster and Pandemic Response --------------------------------------------------------------- - - - - - - - - - - - - - - Public Adherence, Surveillance, and Data in Disasters and Pandemics ------------------------------------------------------------------- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Harm Reduction and Substance Use ================================  FIGURE 7: Drivers of Stigma Pathways to Health Outcomes Model fea Of norms. po.ver lack Of Types of Stigma Stigmas ta etc. Stiynas (e g mental u. tuberculcsis) Stigma Oi%rim natOrv ard am g:ctlrayas by ot Hate Stigma Experien Of Intern\*zatim ot and beliefs family; fiends. for ECeSS to. and quaHy Of. ulth services st---s. co pog At rÉk Of assault nd rrEtal and Key areas for intervention Interpersonal neports Irom Ine cruel ruonc medlLn UlllCer - canaua.ca ![Drivers of Stigma Intersecting Stigmas Substance use stigma\*ii Belief that substance use is a retection of poor willpower or moral failure. that people are to blame for their condition; belief that people who substances are dangerous and reckless; beiet that substance use is not a real illness and rxjple could choose to stop\" Social identity stigmas (e.g.. racism. sexual stigrna, gender iden- tity stigma, ageism) and other health-related stigmas (e.g.. rnental illness stigma, HIV stigma) Stigma Practices media portrayals; social avoidance and exclusion by others; discrimination housing (e.g.. denial Of appli- cations, evicton), failure to accornrnodate employæs With substance disorders l Äth systan: Use of or inappropriate language; reduced empathy from profes- sionals and less motivation to meet the needs of people who use substances; lack of in harm reductbn Experiences Of Stigma Enacted stigma (the experience Of unfair treatment): hternalized stiyna (e.g., shame embarrassrnent LGBT02\* people, people \'\"ho use substances, and living with HIV. mental iness or obesity); anticoated stoma; secondary stigma for family, friends, and/or caregivers o Outcomes and Impacts for Affected Populations Decreased use ot health and social services and wality of services received: concealment Of substance use disorder; OSS ot work and limited access to positions: increased risk Of horneIessrEss Health harmir,g coping strategies (e.g.. &olatkjn, scx:ial withdrawa ax\] avoidance, further substmce use) and behaviours (e.g., needle sharing) Health outcomes: Increased risks of pcorer physical health. quality Of life and psßhological (e,g\_, Ower self-efficacy, self estæm and hopelessness): limited LOtake of opioid agonist therapy: poorer cNtcomes for use disorder treatment ](media/image21.png) Сопитшт 0\' SMety Trauma irform«i еже Anti-rac\[sm Cu\[tural HumiIity Cu1turaI "aty Cu1turaI CtNturaI Safety Апар,м МССЛН С ВНО Нит - - - - - - - - - - - - -  Class 12: Workshop 3 -- Preparation =================================== Video 1: Bevel Up ----------------- - - - - - Podcast 1: Playing God ---------------------- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Class 12: Workshop 3 -- Presentation ==================================== - - - - - - - - - Class 13: HIV Criminalization -- Readings ========================================= Reading 1: Toward a Critical Response to HIV Criminalization -- Remarks on Advocacy and Social Justice ------------------------------------------------------------------------------------------------------ - - - - - - - - - - - - - - - Reading 2: CATIE 1-pager ------------------------ - - - - - - - - - - - Class 13: HIV Criminalization -- Lecture ======================================== The Global Context ------------------ - - - - - - - The Canadian Context -------------------- - - - - - - - - - - - - - - - - - - - - - - Barriers to HIV Disclosure -------------------------- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - [Camille's Notes: Closing the 424 course ] Slide 1: Concept map of the course. General idea of what we talked abt during the course (timelines, history, ways to go through ethical analysis, nursing law (yes two sections on it, but law showed up a little throughout the course!) how to apply different principles and laws and ethical frameworks within different settings Slide 2: Course objectives at the end of the course Slide 3: We can only understand whats happening now if we understand how these events, principles, philosophies came to be: why and how do we use these philosophies ? Slide 4: Voice to build moral courage - - - FINAL EXAM!!! - - - - - - - - - - - - - - - - - - EduFlow - Notes: how can we make course content culturally safe? - - - - - - - - - -