Mt. Sinai Hospital, Bioethics Program
People and Roles:
Bioethicist: Kerry Bowman, PhD
Bioethics has "come to denote not just a particular field of human inquiry-the intersection of ethics and the life sciences-but also an academic discipline; a political force in medicine, biology and environmental studies; and a cultural perspective of some consequence ... It has reached into law and public policy; into literary, cultural and historical studies; into the popular media; into the disciplines of philosophy, religion and literature; and into the scientific fields of medicine, biology, ecology and environment, demography and the social sciences" (William Callahan, Encyclopaedia of Bioethics (Revised Edition, 1995), page 248).
Of the many areas of inquiry that fall under the general heading of bioethics, we will focus on ethical issues that arise in an institutional setting such as Mount Sinai Hospital, particularly in those areas called clinical ethics, research ethics, and public policy ethics.
Generally understood, then, our focus is health care ethics. Initially we will concentrate on topics, materials, etc of particular concern to Mount Sinai Hospital and its community (including staff and patients), but in the months ahead, with your assistance, we will develop this page so as to include concerns of general interest to other collaborating hospitals in the Joint Centre for Bioethics, University of Toronto, and to our professions. In order to provide a meaningful stepping-off point, we include here reference to the sorts of issues that are hallmarks of bioethical interest in a clinical setting. Among those that come most clearly to mind are ethical issues centering on, or arising from:
- Health-care professional/patient relationship:
- informed consent
- competence or capacity
- freedom of choice (freedom from manipulation, deception and coercion)
- truth telling
- fidelity and loyalty
- integrity, etc.
- suicide, euthanasia and assisted death
- refusal, withholding or withdrawal of life-sustaining treatment
- substitute decision making (determinations of best interests, the role of advance directives), etc
However, there are other ethical issues that may not be as easily discernable or easy to discuss openly: for example:
- ethics in team care, including the nature of ethical consensus
- organizational ethics and felt voicelessness (issues of power and authority)
- ethical issues arising from diversity (gender, sexuality, religion, culture)
- the ethics of gate-keeping and caring in the face of so-called medical futility or lack of health care resources
- the ethics of being a clinician as well as a researcher
This list is not meant to be exhaustive but merely exemplary. Ethical issues are recognizable not only in the forms of conflicts between or among fundamental moral principles (such as autonomy, beneficence, nonmaleficence, justice) but also in the forms of moral distress arising from conflicts in virtues (such as between personal integrity and loyalty to the patient).
Dr. Bowman has been delivering bioethics services to the Mount Sinai community since 1998.
Mission, Vision, Values:
Our Mission: Mount Sinai Hospital is dedicated to discovering and delivering the best patient care, with the heart and values true to our heritage.
Our Vision: To serve the community as one of the pre-eminent patient care, teaching and research hospitals in the world, providing quality compassionate care and contributing to the development of innovative approaches to effective health care and disease prevention through research and teaching.
Our Values: Our fundamental values allow us to serve our patients effectively and distinguish Mount Sinai Hospital and the Samuel Lunenfeld Research Institute as a model health care centre. These values include:
- Excellence: Pursuing excellence and innovation in everything we do. Our ideas and enthusiasm help us continuously improve
- Service: Providing patient and family-focused care that is sensitive to our multicultural community
- Teamwork: Taking a collaborative and multidisciplinary team approach to patient care, teaching and research
- Collaboration: Creating dynamic partnerships both internally and externally in benefit to patients and our role as a teaching hospital
- Respect and Diversity: Valuing and respecting each other’s differences. We recognize that every person is different and shaped by his/her unique experience
- Leadership: Promoting the development and growth of leaders at all levels through continuous learning and knowledge sharing
Our Goals: To continuously improve ethical dimensions of patient care at Mount Sinai Hospital through consultation, education and research.
Areas of Specialization:
Reproductive ethics, ethics and end of life decision making, quality end of life care, genomics research, transplantation, culture and bioethics, and conflict resolution.
Consultation is provided to:
- all MSH staff, patients and their families regarding any ethical questions
- MSH staff; this may include questions of management, committees and policy development and review
- the University of Toronto
- consultation at a local, provincial, national and/or international level
- Dr. Bowman provides (continuing) ethics education to Mount Sinai staff (e.g., program or discipline specific rounds, discussions, workshops, formal presentations, conferences)
- he teaches and supervises graduate students enrolled in the University of Toronto Joint Centre for Bioethics’ Collaborative Program in Bioethics and MHSc in Bioethics
- he supervises Clinical Ethics Fellows from the Joint Centre for Bioethics on rotation at Mount Sinai Hospital
- he teaches at the Institute of Life Studies and Aging, Collaborative Program in Aging, Palliative and Supportive Care Across the Life Course: MultidisciplinaryResearch Concepts in Palliative and Supportive Care
Dr. Bowman’s current research focuses on culture and end of life in the ICU, culture and brain death, genomics and international research standards. He disseminates research findings through education, publications and conferences.
Clinical Ethicist: Kerry W. Bowman, PhD