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2015 Annual Conference Review – Whose Choice Is It? Ethics and Living at Risk


The annual NSHEN conference, Whose Choice Is It? Ethics and Living at Risk, was held this year in Dartmouth on October 22, 2015.  A panel presentation, Social Media and Professionalism, was also held the evening of October 21. This was the largest conference in NSHEN’s history, reaching our maximum capacity of 140 attendees. Feedback from participants was very positive, indicating that they found the conference content relevant and engaging. Given the great interest in the conference, we are developing a workshop on ethics and living at risk for those who were unable to attend the conference – please see below for more information!

Social Media and Professionalism Panel

The evening panel on social media and professionalism offered an opportunity to explore the topic from a variety of perspectives. Moderated by Marika Warren, the panel speakers discussed ethical issues related to theory, research, practice and policy around social media and professionalism. Amy Thurlow provided insights stemming from her research on social media use in educational settings and the related ethical issues that arise among faculty and students. Tess Laidlaw has studied social media communication during high-risk health threat situations. She highlighted how the nature of expertise is changing due to increased social media use, with the blurring of traditional boundaries between patients, the public, and health care providers. She also presented her framework for understanding how health experts communicate with the public on social media.

Dr. Christine Chambers offered her perspectives as a clinician who is very active on social media herself as well as a researcher studying the use of social media to disseminate health research to parents directly rather than through traditional media. She offered insights into the ethical issues related to the overlap between one’s personal and professional life on social media. Finally, Michael Sangster discussed the issue in the context of his experience developing a telepractice policy and the ethical implications of social media use from an organizational perspective. Overall, the panel agreed that when using social media, health care providers must consider ethical issues such as breaches of patient confidentiality and the violation of both personal-professional and patient-provider boundaries, that social media communication should be subject to the same professional and ethical standards as in-person communication, and that it is futile to ignore the use of social media – instead, we should be working together to consider how we can use it both professionally and ethically.

Ethics and Living at Risk

The aim of NSHEN’s annual conference is two-fold; first, it delivers ethics education to Nova Scotia’s health care providers, administrators and policy-makers, and second it provides a forum for networking and collaboration between people interested in and working on health ethics as part of their professional role. This year’s topic of Ethics and Living at Risk explored a number of guiding questions, including:

• What conflicting values and ethical issues might arise when providing care to those living at risk?

• When individuals are living at risk, is our primary obligation to them or to others who may be affected by their choices?

• How much harm to others and/or harm to oneself is sufficient to limit the right of an individual to live at risk?

• How can health care providers support individuals who are living at risk? Should they?

• What is the difference between accepting risk in one’s own life and supporting others to live at risk?

• In what ways can risk be a positive value?

The morning began with a plenary panel discussion led by Patti Melanson who works with the Mobile Outreach Street Health (MOSH) team at the North End Community Health Centre.  She, along with Christy Simpson and John Fraser, described some of the ways in which MOSH supports individuals living at risk and the personal and professional ethical challenges that arise in the course of providing care for these clients. 

Breakout sessions followed, each exploring living at risk from different perspectives. Christy Simpson addressed the ways in which organizations shape and influence decisions to live at risk, while Catherine-Anne Murray and Kathryn Hominick presented their work around the Dignity of Risk, focusing on elder populations.  Donna Sutton looked at the effect of practice context around the ethics of living at risk, focusing on those who work in community and home care, Gaynor Watson-Creed discussed the ways in which public health responds to real, perceived, and theoretical risks as well as the ways in which public health messages influence choices around risk, and Patricia Murray looked at choices around risk in youth, for whom risk taking is part of normal development in adolescence.

The breakout sessions prompted lively and rich discussions.  Some themes that emerged from these discussions included the challenges of distinguishing “acceptable” from “unacceptable” risk, the way that values affect perception of and response to risk, and the range of ways that we address risks, both “big” and “small”, in daily practice.  We hope that the conference provided an opportunity to take a step back from practice and reflect on the many decisions that we make every day about risks and particularly on how values influence those decisions.

We welcome any further feedback you have on this event, as well as suggestions for future conference themes. For those who are interested in viewing them, we have posted the speakers’ presentations on our website.  Thank you to all of our speakers and participants for your contributions to the event; we appreciate your support and enthusiasm for developing health ethics capacity in Nova Scotia.

2016 Living at Risk Workshop: Whose Choice Is It Anyway?

NSHEN is please to offer the follwing workshop:

Living at Risk Workshop: Whose Choice Is It Anyway?

February 10, 2016

Yarmouth, NS 


March 10, 2016

Sydney, NS

Individual choices to live “at risk” can test commitments to the principle of respect for choice. They often challenge us to re-examine the values that drive health policy and health care practice.

Drs Christy Simpson and Marika Warren from the Nova Scotia Health Ethics Network present highlights from our sold-out 2015 conference “Whose Choice Is It? Ethics and Living at Risk”. This workshop will focus on key points from our conference sessions on the following topics; vulnerable populations, community care and home care, public health, and dignity of risk.

We will provide the opportunity for participants to reflect on living at risk and the important ethical questions that it raises about what it is to provide good care and what it is to live a good life.

Workshop Objectives:

• Describe what “living at risk” looks like within your practice

• Describe ethical concerns related to living at risk

• Describe challenges raised by living at risk from a range of

• Discuss why caring for individuals living at risk can be so challenging


Registration will be open Tuesday December 8, 2015.

All registrations must be completed on-line:

Click HERE for Yarmouth 


Click HERE for Sydney

Registrations must be received on or before Tuesday, February 2, 2016 for the Yarmouth workshop and Tuesday, March 2, 2016 for Sydney.

The cost of this workshop is $35.00

Space is limited so please register early.


NSHEN Case Database Now Available 


This database of cases was developed as a educational tool to support ongoing efforts to enrich your capacity to recognize, analyze and address ethics concerns related to patient/family-focused care, professional practice, and policy development. You are free to use the content of this resource for your teaching and learning needs; we ask only that you acknowledge the Nova Scotia Health Ethics Network (NSHEN) as the source.

Unless otherwise indicated, the cases presented in the database are fictional or have had significant details fictionalized to respect confidentiality and privacy concerns. Some have been adapted from previously published materials (details indicated following the case).

Each case in the database includes one or more questions as well as a list of relevant values and ethics issues to help get the discussion started. These are only suggestions and certainly not exhaustive- feel free to adapt the cases, discussion and analysis to suit your own learning needs. As you consider a case, keep in mind that often there is no single “right” answer, but some will be “more right” than others. Reflecting on this and trying to understand why it may be so is a big part of working through the analysis and developing potential solutions for each case.

Here is the link to the NSHEN Case Database.

You can also download this case database as a PDF document on the NSHEN website.


Fireside Chats


NSHEN continues to create Fireside Chats, and we will have new videos available for viewing in the next couple weeks. Some available videos include; Dealing Ethically and Collaboratively with Difficult Patients, and Disability, Dignity and Medical Aid in Dying.  These short video discussions, accompanied by discussion questions and resource lists, were developed as education tools for ethics committees and health care teams.

You can watch these videos here

New Featured Article Now Available


NSHEN has developed a new educational resource: Featured Articles. We will be choosing articles from the recent health ethics literature that we think will be of interest to ethics committee members and others working in the health care system. We will create a summary of each article for those too busy to read it in its entirety and, through our agreement with Access Copyright, will provide the full article to those who are interested.

The newest article summaries; Patient Satisfaction Surveys on a Scale of 0-10: Improving Health Care, or Leading It Astray?, by Alexandra Junewicz and Stuart J. Younger, are available here. If you would like a copy of a full article, please contact NSHEN.

Bioethics Book Club

NSHEN has developed the Bioethics Book Club as a resource for ethics committees, organizations and health care teams looking for a fun, creative, and interactive way to facilitate discussion about health ethics issues and engage in ethics education.

We will select a variety of books with health ethics themes - both fiction and non-fiction - and develop a handout for each that includes a summary, a list of some of the ethics issues addressed in the book, and discussion questions.

Your group will select the book that is most relevant or of interest to you, give your group members time to read the book, and then use the discussion questions as a guide to facilitate a group discussion around the health ethics issues within each book and how they relate to your practice.

Recent additions include:

Gailieo's Middle Finger by Alice Dreger

Mountains Beyond Mountains by Tracy Kidder

Stiff: The Curious Lives of Human Cadavers by Mary Roach

My Sister's Keeper, by Jodi Picoult

Final Exam: A Young Surgeon's Reflections on Mortality by Pauline Chen

Some of these books are available in the NSHEN Lending Library and most are available through Nova Scotia's public libraries.

Please continue to check back here as we add more books to our list. Also, if you know of a book not on our list that would be a good fit for Bioethics Book Club, please let us know!

National Health Ethics Week


Save the date! Next year's National Health Ethics Week will take place April 4-10, 2016.

Please contribute your ideas and share your feedback on last year's initiative by completing a short evaluation here:

For more info on National Health Ethics Week, please visit

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Table of Contents

Book Library

 NSHEN currently has a library of books that may be of interest to

Recent additions include: The Ethos of Medicine in Postmodern AmericaWhat Patients Teach: The Everday Ethics of Health Care and The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age.

 Please check our website for complete listing and contact the
 Administrator to arrange a book loan.

What Makes NSHEN Unique?

 While there are other  ethics networks and  centres across the  country, there are a  few features that  make NSHEN unique  within Canada.

 * Our collaborative    structure facilitates  dialogue between  partners

 * Our strategic goals  are collectively  established by the        collaborating      partners

 * NSHEN involves  academia,  government, and  health care  organizations in a  single network.This  results in a network  that is  innovative,  efficient, and  responsive to ethics  needs in Nova

You're receiving this newsletter because you have worked with or are a friend of the Nova Scotia Health Ethics Network.

For general NSHEN information contact the NSHEN Administrator directly:
Krista Mleczko-Skerry | (902) 494-4038
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Dept of Bioethics
Dalhousie University
5849 University Ave
Rm C313, CRC Bldg
PO Box 15000
Halifax, NS, B3H 4R2

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