Building Ethical Competency: Intensive Care Curriculum - 10/27/2026

Wednesday, October 28, 2026, 2:30 PM - Monday, May 17, 2027, 3:00 PM, ICU conference rooms and Teams Live


Building Ethical Competency: Intensive Care Curriculum Description ? Goals: advance ethical knowledge and skills of all members of ICU teams, promote moral resilience, and enhance interprofessional trust/communication. ? CME offered for physicians, APPs, nurses, social work, PT/OT, pharmacy. ? Every other month. Sessions will be recorded for those not able to attend in person. (No CME for watching video) ? Vignettes or de-identified cases will be used to elucidate content, build skills. ? Faculty: 4 core ethics team members; contributions from select ICU team members if appropriate. ? Series may be repeated in subsequent years, pending evaluation by ethics and unit leadership. 1. Conflicts involving legal substitute decision makers • What is the role of the LSDM? o The burden of making decisions for a loved one o Substituted judgement, best interest & value-concordant care o Scope of authority of surrogate vs. POA – Qualifying conditions • LSDM vs. patient o Overturning decisions put into place by patient o Treatment over objection for patient without capacity but refusing • Conflicts between family members o What is a reasonable effort to reach a possible surrogate? o When surrogates of equal status disagree about patient preferences o Supporting the LSDM in context of pressure by family 2. Interrupting Clinical Momentum in the ICU • What is Clinical Momentum? • Timing of Goals of Care Conversations: The Goldilocks phenomenon • Best Case/Worse Case Approach • Effective use of time-limited trials in face of clinical uncertainty 3. Non-beneficial Care • ATS consensus statement: value-laden claims vs. strictly physiological futile • Legal limitations: unilateral withdrawal or withholding, including CPR • “Harm” to patient reconsidered: what is suffering? • Setting limits, framing, and avoiding paternalism 4. Code Status • Effective code status discussions • Suspending DNR during procedures, surgery? • Slow code, soft code • Full code: Knowing when to stop 5. Refusals of Clinical Recommendations • Patient refusals: what do they mean? • Patient refusals: when can we override? • Family refusals: when they conflict with goals of care • Family refusals: bottom lines – pain and symptom management • Leaving the ICU against medical advice 6. Collaboration & Communication • Surgeons vs. intensivists (Peter Angelos article) • Avoiding mixed messages with multiple services • Interprofessional team conflicts • Ethical challenges related to “hand-offs” 7. Unique patient populations & decision making: Unrepresented persons & prisoners • Obligations to care in absence of a decision maker • When to pursue guardianship • Shared decision making with a guardian • Rights of prisoners with capacity: visitation, communication, shackles • When prisoners lack capacity: identifying and working with a legal substitute decision maker 8. Donation after Cardiac Death • Ethical guidelines for care of donor as patient/person • Maintaining separation of treating team and procurement team/GOH • When patient is a registered donor: implications for timing of withdrawal, family rights

1. Describe current ethical issues in critical care that impacts medical decision making.
2. Develop strategies to enhance interprofessional teamwork.

The Northwestern University Feinberg School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation Statement

The Northwestern University Feinberg School of Medicine designates this live activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AMA PRA Category 1 Credits™ (1.00 hours), ABS CC (1.00 hours), Non-Physician Attendance (1.00 hours)

Mitigation of Relevant Financial Relationships

Feinberg School of Medicine adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to control the content of a Continuing Education activity, including faculty, planners, reviewers, or others are required to disclose all financial relationships with ineligible entities (commercial interests). All relevant financial relationships have been mitigated prior to the commencement of the activity.

No faculty are available for this activity at this time.