Emerging Ethical and Legal Challenges in Chronic Neurological Conditions

The care of patients with serious chronic neurological conditions poses difficult ethical and legal dilemmas that extend beyond the acute care setting. This conference provides an opportunity for participants to engage in discussions regarding continuously emerging and profound legal and ethical challenges.
The topics for this conference include:

• Obligations to provide or withhold innovative or alternative therapies
• Societal and social issues in our new healthcare systems and the problem of stigma
• Nonepileptic seizures and other conversion disorders: A dialogue about emerging issues
• Public Health & Epilepsy: Considering driving, guns, and advocacy

The format of the conference will offer framework presentations by leading individuals from medicine, law, and ethics, followed by structured exploration and discussions. The paradigm of epilepsy will be used to highlight many of the ethical dilemmas, but there will be connections drawn to a variety of neurological illnesses such as multiple sclerosis, early Alzheimer’s, chronic pain, and Parkinson disease that span from pediatrics to geriatrics.

This conference will provide:
• An exploration of dilemmas that arise in an outpatient setting that are relevant to clinicians, ethicists, and public health scholars.
• Practical ethical frameworks and tools to navigate these dilemmas.
• An opportunity for audience members to actively engage in developing new approaches and solutions.

Neurologists, neurosurgeons, psychiatrists, lawyers, advance care nurses, physician assistants, ethicists, psychologists, health services specialists, and social workers who address practical and ethical challenges related to chronic neurological conditions.

Day 1 – October 8, 2014
1:00-1:30 Registration

1:30-3:15 Ethical Challenges with Refusal of Recommended Therapy: Alternative Therapy, Surgery, and High Risk Medications – Douglas Diekema, MD, MPH
Short Presentation – Cannabis: The Raging Debate – Camilo Garcia, MD
Short Presentation – Off-Label and Newly Approved Devices – Carmen Paradis, MD, MA

3:30-5:00 The Presidential Bioethics Commission’s Report on Incidental Findings: Applications for Neuroscience Elizabeth Pike, JD, LLM
Short Presentation – Applications and Dillemmas of Incidental Findings in Practical Settings – Jalayne Arias, JD, MA

Day 2 – October 9, 2014
8:00-8:30 Continental Breakfast/Registration

8:30-10:00 Ethical Implications of ACA and Contract Refusal with Specialty Centers: Complex Patients at Risk?
Valerie Blake, JD, MA; Respondent: Mark Votruba, PhD

10:15-11:45 Stigma in Chronic Neurological Diseases: Ethical Challenges in Creating Change
Tatiana Falcone, MD, Jane Timmons-Mitchell, PhD and Paul Ford, PhD

12:00-1:00 Lunch: Nonepileptic Seizures – Dialogue About Emerging Ethical Issues – Xavier Jimenez, MD

1:15-3:00 Neurological Disease, Capacity and Personal Responsibility – Jennifer Chandler, JD
Clinicians’ Obligations to Public and Home Safety: Gun Ownership and Safety – Babak Tousi, MD
Short Presentation – Clinicians’ Roles in Restricting Driving for Patients with Cognitive Impairment – Bryn Esplin, JD

3:15-4:45 Technical and Neuroethical Challenges in Pain Control: Addressing Harms of Commission and Omission
James Giordano, PhD
Short Presentation – Experimental Brain Surgery for Intractable Pain: Surgeon’s Perspectives of Ethical
Challenges at the Translational Edge – Andre Machado, MD, PhD; Respondent: Bryan Kibbe, PhD

4:45-5:00 Close