These posters will be available :

• Ab Manan M., Tan M. Baby Steps: Growing Clinical Ethics Services for Pediatrics in a Malaysian Teaching Hospital
• Applewhite M. ETHICS CONSULTATION SERVICES AND SURGEONS: HOW TO BUILD TRUST AND COLLABORATION"
• Asif M. Bridging Gaps and Enhancing Bioethics Education in Pakistan: A Capacity Building Initiative
• Berger L. Welcoming Siblings into French Pediatric intensive care units, an overview of French practices 
• Clavien C. Ethical issues raised by applying good ACP practices to ICU instructions
• Corsico P. Engagement and normativity: What is the aim of patient engagement in clinical ethics?
• Crowell P. Cultural Accommodation, Conflict, and the Challenges of Plurality: An Ethical Case Study that Exams Competing Rights in Healthcare
• Crowell P. Indigenous Power within Healthcare:  In Search of a Delicate Balance Between Pediatric Oncology and Indigenous Children
• Dallaire C. Hidden Curriculum in Medical Education: Action Research for the Development of a Participatory Reflective Tool 
• Ehlers U. The `St. Gallen Resuscitation Decision Algorithm`
• Eijkholt M. To disclose or not to disclose. What the HEC(k) between medical law and medical Ethics
• Ferrie M. Intersexes children: what role does clinical ethics play between a new law and traditional medical practices? 
• Fumie A. The Meaning of Experiences of Communicating about heredity in Early Genetic Diagnosis of Muscular Dystrophy
• Gillam L. and Court A. Parents driving too much medical treatment for their child - Responding to the ethical challenges
• Goset K. Enhancing Patient Autonomy: An Advance Care Planning/Advance Directives Initiative by a Healthcare Ethics Committee.
• Hulkower A. Vicarious Trauma and Compassion Fatigue in Clinical Ethicists: Defining the Service Director's Role
• Jacques R. Principled approach to comingled human remains 
• Knochel K. Principle-based ethical case analysis as a tool for normative conflict resolution in pediatrics
• Lacharité F. Gaucher N. and Lavoie  B. The best interests of the child and the withdrawal of life-sustaining interventions: exploring a principle open to interpretation
• Landi A. Navigating Difficult Conversations: A Pilot Training for Clinical Ethics Fellows in Palliative Communication Skills
• Landi A. Requesting permission to consult palliative care: Patient-driven instead of patient-centered
• Lavoie B. Going to court: exploring the motivations of pediatricians in situations of treatment refusal expressed by parents
• Lavoie B. Value, Bridge Builder, or Obstacle? Clinical Perceptions of Parents' Religion in Complex Pediatric Situations
• Le Bourgeois F. Parents from a Roma community refusing treatment in paediatrics, place of the principle of autonomy  
• Lin K. The Case for Independent Clinical Ethics Committees: A Novel Structural Proposal for Healthcare Ethics Consultations in Singapore
• Mann D. MD DBe HEC-C Complicit with the illicit, how physician involvement risks condoning unorthodox parental behavior.
• Masilla S. Prognostic uncertainty and Shared Care Planning: a case of a Fetus with Severe Renal Hypoplasia and Early Anhydramnios
• Menon S. Not just advisory: Clinical Ethics Committees as the approving authority for innovative salvage treatments for patients
• Mesnage V. How clinical ethics changed my outlook and made me a committed citizen
• Moazzen V. Contribution of Forensic Medicine Specialists to Clinical Ethics Consultation and Legal Advice in Iranian Hospitals
• Moreno-Molina J. Transnational Reproductive Medicine and the Role of Clinical Bioethics: The Case of Colombia
• Moreno-Molina J. Clinical Bioethics Training for Surgical and Medical Residents: The Universidad CES Experience
• Nikolakakis I. Bioethics and Bioterrorism: Past, Present, and Future
• Patten C. Ethics on Record: A Study of Clinical Documentation Practices in EHRs
• Rhodes R. Innovation in Collaborative Clinical Ethics Consultation
• Robin M. Increasing Outpatient Life-Sustaining Treatment Discussion and Documentation in a Veterans' Administration Outpatient Clinic
• Rosca A. Ethical Conflict Resolution Through Shared Decision-Making and Advance Care Planning for Incapacitated Patients
• Šteina E. The Ethical Dilemmas of Slow and Show Codes in Healthcare 
• Tareen M. Surrogate decision-making and ethical dilemmas in palliative care: balancing patient autonomy in Muslim-majority settings
• Yip E. Navigating Ethical Dilemmas of Disclosure and Role Clarity for Medical Shadowing: A focus on Hong Kong's Public Hospitals

1)    Gillam L and Johnston C. From conceptual to concrete: learning ethics in a clinical ethics committee for medical students

Abstract :
"Medical students witness and experience ethical challenges during their clinical placements.  Student Clinical Ethics Committees (SCECs) have been established in some universities globally, as an experiential learning initiative to support students to navigate and reflect on these challenges, developing skills of professional practice.  In 2024, we piloted an SCEC as an enrichment opportunity for medical students at [blinded for peer review].  

The staff involved in the project lead clinical ethics committees within hospitals, and aimed to replicate this experience for the medical students. Each meeting was an ethicist-led discussion of a de-identified case referred by an MD student, with case notes prepared by a volunteer notetaker.  The training, referral process and model of ethics deliberation used in the SCEC reflect the real-world functioning of hospital clinical ethics committees.

The student response in the pilot year has far exceeded our expectations.  In order to include all enthusiastic students, we established three parallel committees each of which met online every two months.  Students have submitted a diverse range of complex and perceptive referrals which have stimulated excellent discussions.  
The digital format strove to promote a plurality of perspectives across various clinical and geographical settings. We value this innovative learning model as a preventive form of health ethics consultation, supporting future clinicians to be better placed to respond to ethical issues, while shaping their professional and moral identities. This presentation will discuss the design and experience of the SCEC including governance, confidentiality, risk management, types of clinical ethics issues raised, and student learning outcomes.  

In our view, an SCEC is an effective way of bringing the workplace into ethics teaching, enabling development of practical ethics skills. It builds a cohort of peers interested in ethics and, we hope, will contribute to nurturing future leaders in clinical ethics in our context. "

2)    Fiester A. Abdicating the Role of Mediator in US Healthcare Ethics Consultation: A Risky Choice 

Abstract:

The amount of conflict between patients, families, and healthcare providers is so high in the United States that a recent consensus statement of five professional medical societies recommended embedding expert conflict management consultants in all high-volume US hospitals (Bosslet et al 2015).  From the earliest days of formal ethics consultation, the US bioethics organization, the "American Society for Bioethics and Humanities" (ASBH) deemed conflict resolution skills as a core competency for ethics consultants, making the institution's ethics service a natural locus for such conflict management experts.  But over the last 25 years, clinical ethics consultation in the US has morphed into a consulting specialty similar to medical subfields like nephrology or hematology, in which the primary deliverable is knowledge-based expertise and judgment. Most US ethics consultants offer recommendations, not interventions. Even among ethics consultants with the ASBH's new formal certification (HEC-c), very few ethics consultants have any training in conflict management, despite the mandate for both in the ASBH's Core Competencies, the guiding document for the field.  I will argue that this evolution (or devolution) of ethics consultation in the US may be sowing the seeds of its own demise. Over the last 10 years, US hospitals have increasingly relied on newly emerging Departments of Patient Relations to fill the void of conflict management expertise that ethics consultants could have (and, I believe, should have) filled. These new departments are typically larger and much better funded than the hospital's ethics consult service. In fact, most US hospitals have a patient relations department though many hospitals have no paid ethics consultants at all.  If this trend continues, abdicating the role of conflict resolution in ethics consultation may put clinical ethics “out of business.'

Bosslet, GT., et al. "An Official Policy Statement: Responding to Requests for Potentially Inappropriate Treatments." 191(11),2015: 1318'30.

3)    Semler L. Mediator or Advocate? The Role of the Clinical Ethicist

Abstract:

"Mediation is an essential component of ethics consultation. The practice of mediation uses a neutral facilitator to foster engagement of all stakeholders and their respective interests and perspectives, and facilitate a resolution or consensus on an ethically justifiable course of action. However, when, if every, is it justifiable for the clinical ethicist to step outside of the bounds of their role as mediator and advocate for what they feel to be the right course of action?
The author will describe a case in which the interests of an incapacitated patient are discovered through interview of his wife and guardian. However, neither the wife nor the attending physician is willing to move forward with the ethically appropriate course of action to uphold the patient’s previously expressed wishes. In cases like this, what are the clinical ethicist’s responsibilities to advocate for the most ethically appropriate course of action? Clinical ethicists are consultants, and ultimately the decision-making rests with the clinical team and patient or family. However, when the patient cannot speak for themselves, and their loved ones refuse to do so, does the ethicist have an obligation to step outside the role of neutral mediator and instead advocate for the voice of the patient? At what point would the ethicist seek institutional or legal support to advocate for a specific course of action? The author will provide support and considerations for both perspectives, along with considerations for a deontological vs consequentialist approach to consultation recommendations."

4)    Reato F. Repertoire of the Competencies of the Clinical Ethics Consultant in the light of the European and Italian Qualifications Framework

Abstract:

For the public recognition of the qualification of the Clinical Ethics Consultant (CEC) it is necessary to build the Repertoire of the Competencies by the European Qualifications Framework (2008, 2017) and the Italian Qualifications Framework (2012, 2016, 2018) criteria. Highlighting the clear connection to the EQF level 8, we identified and described learning outcomes of the identified competencies through knowledge, skills, autonomy and responsibility. 
Methods/Materials:
To reach data saturation, according to the qualitative research approach, an ethnographic study was conducted according to the principles of the ""At Home Ethnography"", through Participant Observation and Interviews to the Double (Alvesson, 2009, Nicolini, 2009). The interviewees are asked to imagine a hypothetical replacement by a ""Double"" who will take their place in the execution of the work activities and to provide him with all useful indications to cover the role of the CEC best.
Results:
Taking into account also the European Skills Frameworks Entrecomp, LifeComp and DigComp, was identified 11 Transversal Competencies (01. Communication and Interpersonal Relationship, 02. Coping With Emotions, 03. Problem Solving, 04. Critical Thinking, 05. Decision Making, 06. Self Awareness, 07. Leadership, 08. Team Work, 09. Time Management, 10. Governance of Digital Transformation Processes and Technological Innovation, 11. Teaching Competencies) and 6 Technical Professional Specialist Competencies (1. Determine the nature of uncertainties or moral conflicts that require clinical ethics consultation, 2. Conduct the clinical ethics consultation process in the health area, 3. Encourage the resolution of moral uncertainties and conflicts by facilitating the construction of an ethically based solution, 4. Document planned and implemented clinical ethics advice in the health field, 5. Monitor clinical ethics consultation service, 6. Improve the quality of clinical ethics consultant service). 
Discussion and Conclusions:
The Double Instructions and the Participant Observation allow: tracing of the tacit routines put into place and interpreted by each Professional, through the exercise of the narration of micro-actions and daily practices, identifying attitudes, knowledge, skills, emotional and intentional colors of their professional actions, identifying spaces of autonomy and responsibility, learning more about the actions and reasons for the practices of fellow Clinical Ethics Consultants. "
 

5)    Bonaccorso A. Workplace violence against midwives and midwifery students: moral dilemmas and challenges for Healthcare Ethics Consultation (HEC)

Abstract:

Workplace violence (WPV) against healthcare professionals represents a global issue. Violence in the maternity setting has received little research attention, with midwives often assimilated into nurses. Few studies, primarily qualitative, have explored the effect violence has on midwifery students whilst clinical placement.

Methods: An online, anonymous survey was sent via email to all members of Local Midwifery Boards in Italy and to all Italian midwifery students, investigating their experiences of WPV and bullying.

Results: The findings highlight the high exposure to violence that midwives and midwifery students experience in the workplace. A total of 1059 completed questionnaires were returned by eligible participants, 687 midwives and 372 midwifery students. Forty-five percent of midwives and 27% of students reported being a victim of WPV. This was most often in the form of verbal abuse. The women's partners or other family members (65.4%), patients (21.9%), and physicians (29.1%) were identified as the main perpetrators by midwives. Midwifery students experienced bullying mostly from supervising midwives (40.2%) or other midwives (56.8%). Over half of the victims did not report and seek assistance through formal channels. Consequences of WPV included thoughts of leaving their job (27.1% of midwives) or course of study (22.5% of students) and significantly reduced gratification from caregiving.

Discussion and Conclusions: Healthcare professionals face the following moral dilemmas: providing care to patients who have attacked them, manage emotions so as not to let them to interfere with care, balance the responsibility of protecting their own integrity and safety with professional duty and with respect for dignity of the patient. HEC can offer a listening space for victims and create the conditions allowing for the reporting of facts. In this listening space, ethical consultant can help to explore and resolve these conflicts through an analysis of professional and moral values. Also, HEC can help to create corporate awareness on the topic so that adequate prevention measures are implemented. "

1)    Kühlmeyer K. Can we identify needs for clinical ethics services by screening for moral distress?

Abstract :
"Introduction: Experiencing ethical challenges in health care can be accompanied by moral distress (MoD). Studies have shown that clinical ethics support services (CESS) can be effective in mitigating MoD of health care professionals. We explore whether a screening for MoD can be used as an indirect needs assessment for interventions by CESS. 
Research Question: How can structured MoD screenings be used to assess needs for CESS?
Main body: We present results of an ongoing mixed-methods study and a reflection of its utility for CESS. We used psychometric test instruments for MoD screening at a German University Hospital: the Measure of Moral Distress for Health Care Professionals (MMD-HP) and the moral distress thermometer (MDT). The screened sample consisted of 143 nurses and doctors of six pediatric and neonatal intensive care units (PICUs/NICUs) (49% of the population). Between the professional groups, the level of MoD was comparably high and the most common causes were directly or indirectly associated with resource scarcity and a lack of communication. The staff of the PICUs reported higher levels of MoD. First results of qualitative interviews with 19 purposefully selected employees (nurses, doctors, psychologists and social workers) showed a variety of specific causes. For example, communication problems occurred because of a lack of spaces for interprofessional discussions and unstructured handovers, or resource scarcity was reinforced by changes in professional training and extensive documentation of patient data. The reasons for MoD go beyond case-based conflicts and point to causes of moral distress at structural levels. CESS and teams with high levels of MoD could develop needs-based interventions to tackle such causes together. 
Outlook: We will explore connections between the identified causes of MoD and suitable interventions based on expert interviews with clinical ethicists."

2)    Brogtrop L. Does series of moral case deliberation increase social safety and moral courage? A pilot at the Dutch Government

Abstract:
"Context. 
After a national scandal in 2021, the Netherlands created the governmental program Dialogue & Ethics, which focuses on creating a governmental culture in which ethical reflection is a standardized element. The aim is to achieve this by facilitating guided moral dialogues (consisting of various forms of Moral Case Deliberation) throughout the entire Dutch government. The goal of these dialogues is to help public officials in recognizing and addressing the ethical dimensions of their daily work. In addition, the dialogues ought to contribute to a governmental culture in which ethical questions and concerns are included in decision making processes.
Research question. 
What is the impact of the Dialogue & Ethics program, and how to measure that impact?
Method. 
This PhD project focuses on identifying the impact of the Dialogue & Ethics program. To further specify the domain of impact, four outcome parameters have been identified, namely, social safety, moral courage, moral learning, and (loyal) contradiction. 
In order to measure the impact, a mixed method study will be conducted on four different research locations that commit to conducting various forms of MCD with their team, over the course of one year. These methods consist of ethnographic fieldwork, a questionnaire that has been developed specifically for this research, interviews, and focus groups. Currently, this questionnaire is in a developmental stage, but during the ICCEC conference the questionnaire will have been finalized.
Discussion. 
Do CESS foster social safety, moral courage, moral learning and contradiction in healthcare contexts? Are there possible harms CESS can create, and, if so, how do these harms compare to a governmental context? 
What are relevant similarities and differences between conducting CESS in 'traditional' contexts versus political contexts? Can the aforementioned research parameters also be relevant for CESS?"

3)    Zlotnik Shaul R. Moral distress debriefs: An opportunity to increase “moral peace” in the health context

Abstract:
"In this post pandemic era, rates of healthcare provider burnout are being reported at crisis levels across the globe. While many health systems are making huge financial investments into strategies to prevent their most dedicated clinicians from leaving health care, expensive solutions being dangled before the desperate eyes of hospital leadership, regularly miss a key socio-politically grounded feature of burnout.
The depleting sequelae of moral uncertainty, moral distress, moral injury and even moral stress are linked to conflicts that are not surprising within social systems marked by a plurality of values. We must not become complacent, in thinking that moral compromise is solely an individual’s responsibility or in thinking that interventions such as yoga, ergonomically correct chairs or even mindfulness courses, are effectively tailored to addressing these serious contributors to healthcare provider burnout. Recent research highlights an increasingly recognized bi-directional relationship between a definition of moral distress and burnout, revealing moral distress as a cause of burnout and burnout contributing to moral distress severity.
There is an urgent need for a strategy to address moral distress and burnout: one that we argue, needs to be sensitive to the diverse socio-political contributors. This strategy also needs to be adaptable to a range of health care systems with various levels of ethics consultation support. Our ethics team with training in bioethics, nursing, medicine and worked together to develop amoral distress reflective debrief tool aimed at moving those experiencing moral distress to the “moral peace” characterized by greater clarity regarding the moral tensions at play and regarding a plan for next steps.  
Our presentation will describe (1) the bi-directional relationship between moral distress and burnout with particular attention to the impact/influence of socio-political challenges, (2) the self-administered or ethicist-led moral distress debrief tool and (3) the ongoing roll out and evaluation."

4)    Mcloughlin P. Moral Distress Across the Whole Treatment Team: Who Feels What and What Do They Want

Abstract:
"Introduction: Moral engagements are a deeply inherent and intractable component of modern healthcare practice. These challenges affect not only healthcare providers (HCPs) but also patients and their loved ones, healthcare organizations, and the wider community. When these ethical uncertainties, conflicts, and dilemmas are unable to be resolved satisfactorily moral suffering ensues. Moral distress is a particular form of moral suffering experienced because of situations in which HCPs are aware of a moral problem, assume moral responsibility for the issue, and subsequently make a moral judgment as to what they believe is the right word or action to take (or not take). Healthcare ethics consultations (HECs) are often requested when significant moral distress is at play in the team. In fact, some centres now have a separate moral distress consultation service for these types of issues. 
Purpose of research: The purpose of this research was to explore the phenomenon of moral distress, through an interdisciplinary research lens, looking at the whole multidisciplinary team caring for patients requiring long-term ventilatory support. These HCPs were drawn from the disciplines of nursing, medicine, respiratory therapy, physiotherapy, spiritual care, pharmacy, and social work. This study is unique in exploring moral distress in this population and environment.
Methodology: An interpretive phenomenological research method was employed. The Measure of Moral Distress for Healthcare Professionals (MMD-HP) validated questionnaire was completed and in-depth interviews undertaken.
Results & Discussion: This doctoral research highlights that moral distress is not a homogeneous phenomenon of experience amongst the separate HCPs. There are significant differences in the causes, sequalae, and self reported socio-political solutions for the different team members. It is also seen that moral distress may be experienced not only by the HCPs but also by patients and families. HCPs provide personal wisdom for how we might avoid conflicts in the first place."
 

5)     Höpfer D. and Hider G. Who is to Blame? Identifying Responsibility and Accountability in HEC Conflict Resolution

Abstract:
"When healthcare ethics consults require conflict resolution, consultants often encounter parties who place blame on others. In some cases, the person who is blamed is at fault, but in many cases blame is placed for behaviors or characteristics that are irrelevant to the matter at hand. Patients are sometimes blamed for their illnesses, one medical service might blame another for a perceived fault. Fault assumes failure. The act of blaming labels the one blamed as a failure, establishing an unwillingness to communicate and creating the need for conflict resolution. Sadly, it is all too easy to adopt an attitude of blaming. Perceptions of blame play out in an emotional response to moral distress. A cognitive response can offer a different perspective that can potentially draw the emphasis away from fault-finding and re-orient to resolution.
Rather than engaging in placing blame, healthcare ethics consultants can identify actual responsibility and accountability. Responsibility is an attempt to define goals and processes amid uncertainty. Accountability is outcome-based and provides the basis for evaluation of goals and processes. Understood together, responsibility and accountability can provide insight into what happened, what are the consequences of what happened, and how to proceed.
The presenters will demonstrate a Responsibility and Accountability model. The concepts of the model draw from a multi-disciplinary approach to clarify ethical uncertainty and emotional bias. The model reflects a real-world application process that is intended for use in clinical settings. Use of the model can aid in identifying responsibility and accountability while avoiding passing blame, thereby facilitating collaborative communication and conflict resolution."

1)    Johnson L. Preventative Ethics in the Pediatric Intensive Care Unit: Implementation of a Time-Based Automated Ethics Rounding Service

Abstract :
"Background:  Empirical evidence shows that perceptions of non-beneficial treatment and questions about goals of care cause moral distress among clinicians and are a common reason for ethics consultations. These situations arise commonly in the pediatric intensive care unit (PICU), early involvement by palliative care and ethics is recommended in professional guidelines.

Aims: We sought to assess the feasibility and acceptability of using a time-based automatic consult order to the clinical ethics service to facilitate the early involvement of ethics into interdisciplinary rounds as a form of preventative ethics in a subspecialty PICU.

Methods: Using the capabilities of the electronic medical record (EMR), an ethics consultation order occurs automatically on ICU Day 5. Ethics reviews the patient's EMR and assigns a priority to the request (urgent-round in ICU within 48 hours, standard-round within 72 hours, or low-patient expected to leave ICU, follow remotely).  An ethics rounding note is placed in the EMR following rounds unless the consultant identifies the need for a full consultation. After the initial rounding encounter, ethics follows the patient until death or ICU discharge. The Armstrong Clinical Ethics Coding System is used to track the clinical ethics issues in each case.

Results/Discussion: We will present 6 months of preliminary data including demographics, reasons for ICU admission, clinical ethics issues identified and will discuss the feasibility of implementing a time-based system for the early involvement of clinical ethics into the PICU. Our anecdotal experience with ICU rounding indicates that an automatic rounding process normalizes the role of clinical ethics in the ICU setting, serves as a form of preventative ethics, is acceptable to patients and medical staff, and is not overly burdensome to the ethics service. Institutions considering a trigger-based rounding system may wish to customize their automatic triggers to suit their individual needs."

2)    Spiegel J.L. Decision-Making in the PICU: Balancing Medical Scarcity and Parental Autonomy

Abstract:
"A nine-month-old infant was admitted to the pediatric intensive care unit (PICU) with severe hypoxic ischemic encephalopathy after drowning. Despite a tenuous initial course, he was stabilized on mechanical ventilation and nasogastric tube feeds. He was not a candidate for extubation as he did not have the cough or gag reflexes required to protect his airway. His family was left with a decision: compassionate extubation with transition to comfort care or pursuit of a tracheostomy and a gastrostomy tube for long-term care.

Decision-making supports for the family included brain imaging (MRI and nuclear scans), subspecialist consults (pulmonology, neurology, physical medicine & rehabilitation, and palliative care), family meetings, medical device demonstrations, and parental support groups. Despite these measures, the child’s parents were unable to make a unified decision for over a month. They identified familial discord, religion, guilt, and medical uncertainty as hindrances to decision-making.

In pediatrics, parents/guardians have the responsibility to act in the best interest of their child. In most instances, they have a right to choose desired treatments and to provide informed consent for interventions. Physicians, however, should only provide care where the potential benefits to the child outweigh the possible harms. Fulfillment of this ethical mandate may be complicated by unforeseen harms, by the prospect of physiologic futility, and by moral distress. There are also system- and community-level justice considerations in fair allocation of ICU beds, ventilators, and diagnostic tests, all of which are limited resources. Would it be ethically justifiable to limit the time permitted for parental decision-making for a critically ill but stable child?  What biases might influence imposition of such a time limit? What supports could be added to help both parents and health care teams in the decision-making process?"

3)    Kates Rose J. Parental experiences of DM in the grey zones of neonatal intensive care: an international multi-centre mixed methodology study

Abstract:
"Background
In the neonatal intensive care unit (NICU), grey zones – situations where multiple morally acceptable decisions exist – often arise. Sharing decision-making (DM) with caregivers in these contexts is complex. Moral distress (MoD) is well-documented in clinicians, but caregiver moral experiences remain unknown.

Aims
To elucidate caregiver moral experiences of DM in NICU grey zones, particularly, to establish whether MoD and moral schism are present.

Methods
This was a mixed-methodology phenomenological study. Parents of infants who were admitted for 3 or more days between 2018-2022 and who engaged in complex conversations surrounding care plan decisions were invited to complete a survey about their experiences of DM. Bereaved families were not contacted until at least one year following their child’s death. Demographic data were collected through chart review. Descriptive statistics were used for quantitative data. Qualitative data were analysed using thematic analysis, informed by the concepts of moral distress and moral schism.

Results
71 parents (80% mothers) completed the survey. Thematic analysis generated five themes: decision burdens, internal tensions, actualising beliefs and values through DM, inauthentic shared DM, and external factors shaping DM. Overall, 89% of parents wanted to be involved in DM, though only 63% felt included in that process. DM was experienced as burdensome and grey zones elicited tensions within parents about their roles and desires. Parents valued opportunities to actualise their values in the DM process. Despite the goal of shared DM, some parents felt coerced into decisions, consistent with MoD. Extrinsic factors, such as time pressures and partner support, influenced the DM tensions.

Discussion
Facilitating shared DM is complex, reflecting the need for personalised DM and sensitivity to external and internal pressures experienced. Caregivers are subject to MoD and moral schism. A nuanced approach that considers all perspectives may help alleviate tensions and better resolve DM conflict."

4)    Teti S. NICU Complex Care Rounds: A 42-Month Interrupted Time Series Study

Abstract:
"Background
The NICU presents a uniquely challenging environment: the fragility of the patients, the typically long courses of treatment, the hopes and dreams of parents, and close-knit culture can challenge the efficacy of a reactive ethics consultation format, however responsive it may be. An approach to managing value disagreements before they escalate into conflict was needed. Ethical sensitivity and everyday ethics skills needed to be inculcated into practice and embedded in culture.

Aims
This project sought to measure the effects of supplementing existing clinical ethics consultation services with weekly ethics Complex Care Rounds (CCR) in our 106-bed NICU as part of ongoing consult service quality improvement. Any team member (with a focus on nurses) could nominate a case for CCR. Once weekly a multidisciplinary team would meet to discuss the cases with each attending physician in turn.

Methods
A pre/post time series study design was used to investigate impact of the project with the interrupt set at six months after initiation of CCR. 110 formal ethics consults occurred in the 42-month period.

Results
In the post period, the day of the patient's hospitalization on which ethics was consulted decreased from a mean of 32.8 days to 21.2 days. Average case complexity decreased from 2.4 to 2.1 on a 4-point scale. Average length of stay decreased from 73.9 days to 53.9 days. Qualitatively, we found consults involving moral distress decreased 59% while the team's willingness to question some parental choices increased 45%. 

Discussion
As 'basic' consults (help with goals of care) decreased, a broader variety of ethical questions emerged in the post period (as measured with ACECS codes), suggesting consults change, but volumes do not necessarily diminish with increased ethics support. This suggests CCR was effective in raising the capacity of frontline team members to identify ethical issues and manage internally or escalate accordingly."
 

5)    Lukich N. Proactive and Family-Centred: Changing clinical ethics consultation in NICU

Abstract:
"Healthcare organizations strive to provide patient- and family-centred care in order to improve patient experience. Clinical ethics services can support this goal by assisting staff with challenging ethical cases as well as institutions with organizational ethical concerns. Clinical ethics services can demonstrate family-centred care by being used proactively in order to reduce various forms of conflict in clinical environments. This presentation will focus on a model being implemented in a Toronto Neonatal Intensive Care Unit (NICU), where an ethicist is working with staff and families to provide more proactive support and to predict and reduce conflict. 
NICUs face multiple ethical dilemmas which can lead to contention, including the decision to resuscitate and care for premature babies as young as 22-weeks' gestation, options and decisions regarding redirection of care, defining harm and suffering for infants who cannot speak for themselves, parental disagreements, and general moral distress associated with intensive care. While some cases may require reactive support from an ethicist, many of these scenarios could be addressed proactively. This is demonstrated through various actions, such as the ethicist rounding with the nursing and leadership teams on a regular basis, providing education for parents regarding their role, rights, and responsibilities, and empowering all members of an infant's team to collaborate in decision-making. 
While these initiatives have demonstrated success in reducing conflict between staff and parents, there are still challenges that are faced as this new model continues to be implemented, such as increasing understanding of both the purpose and limits of ethics consultation, establishing trusting relationships with parents, and balancing work with the limited resources of an ethics consultation service. Despite the challenges, however, it is clear that this model can be helpful for all NICU staff, parents, and patients in reducing conflicts and ultimately achieving more effective family-centred care."

1)    Bahus M.K. Self-harmers and the right to life. Mediation and conflict resolutions on a collision course with law

Abstract :
"Non-suicidal self-harming is intentionally self-injuring oneself without the intention of dying (Clarke et al., 2019). Examples include swallowing foreign objects or taking a dangerous amount of pain medication. Individuals who self-harm often require immediate medical attention. According to Norwegian law, healthcare professionals are required to treat a patient in an emergency, even if the patient is competent and refuses treatment. This obligation is in line with the UN Convention for the Protection of Human Rights and Fundamental Freedoms, which emphasizes the right to life in article 2.
Many self-harmers refuse necessary treatment, causing healthcare professionals having to use coercion to save their lives. This use of coercion and the attention the self-harmers thus receive, sometimes result in the patients harming themselves more severely on following occasions and also more frequently. The necessary medical treatment, mandated by law, appears to perpetuate negative and health-threatening behavior. These situations also require close cooperation between emergency physicians and psychologists and hence between different departments in the hospital. These challenging situations often lead to a need to seek advice from Clinical Ethics Committees (CECs). To give adequate guidance, the committee must find a way to hold the patient accountable for his or her actions and encourage the patient to choose not to harm him- or herself, without disregarding the health personnel's duty to provide emergency care and the patient's right to life. To facilitate mediation and conflict resolution, the legal boundaries must be carefully examined without compromising the obligation to act in an emergency. How far can we go in negotiating with the patient when his/her life is at risk?"

2)    Neefjes V. Advantages and limitations of a specialist committee deciding on futility in end-of-life treatment decisions 

Abstract:
"In England & Wales both parents and clinicians can refer intractable clinician-parent conflicts to the courts for a decision. However, given the costs of litigation, court cases about withdrawing life-sustaining medical treatment for children in England & Wales are often followed by discussion how to avoid future cases. Whilst two proposals, mediation and the introduction of a harm threshold, have received broad attention, a proposal to replace the court by a specialist review committee has not been further investigated.
This study analyses the effects of a putative replacement of the courts in England & Wales by a specialist review committee using the process enacted by the futility clauses in the Texas Advance Directive Act (TADA) as a model. Briefly, under TADA life-sustaining treatment may be withdrawn when a review committee finds it is futile, and no alternative healthcare provider can be identified within a set period. 
The investigation first considered the advantages of the current court procedures above TADA, i.e. transparency, and suggests a modified procedure that would install a national specialist review committee modelled after TADA. Installing a national review committee to replace the court would reduce the number of court cases in England & Wales to only a few. However a national specialist review committee deciding on futility has further advantages for both clinicians and parents. Advantages for clinicians are more limited exposure to delivery of clinical care that may cause moral distress and less exposure to adverse press and social media content. Advantages for parents are that the process would establish them as ethical decision makers and offer the possibility of a transfer of care provided an alternative healthcare provider can be found. Given the advantages the feasibility of a replacement of the courts by a specialist review committee deserves further investigation."

3)    Smolenski J. Involuntary Treatment for Anorexia Nervosa: Medically Obligatory, or an Exercise in Futility?

Abstract:
"In this paper, I consider the case of severe treatment-refractory anorexia nervosa (AN). Given the nature of anorexia - which involves not only delusional beliefs about one's body, but also impaired cognition caused by starvation – patients with this diagnosis often adamantly resist any efforts at treatment. In some cases, extended periods of involuntary treatment can result in positive results, even remission or cure. In others, AN patients are subjected to repeated, costly treatment against their will, which they actively resist and fails.

AN can lead to intractable refusals of treatment, such that even treatment under restraint may not be enough to generate meaningful clinical improvement. Though patients may indicate that they want to live, and that they know artificial nutrition and hydration (ANH) is necessary to achieve this goal, they may nevertheless remain unable to permit its administration. They may even appear to consent to being restrained at various times, however, the level and duration of restraint necessary for potential improvement tends to be inconsistent with more general practices regarding involuntary treatment (i.e., that it should be used as briefly as possible, as infrequently as possible, and thus is generally not considered practicable for long-term interventions). Furthermore, it is not antecedently obvious that such extended involuntary treatment will even work (let alone be in the patient's overall best interest).  

As such, clinical ethicists are increasingly being consulted about the possibility that ongoing compulsory treatment for treatment-refractory AN-especially under restraint- may be medically inappropriate, and thus morally appropriate (or even obligatory) to withhold or withdraw, even over patient or family objection. This could bring anorexia nervosa into a hotly contested domain -that of a potentially medically-futile psychiatric disorder- and thus of particular relevance to this year's theme of HEC and conflict resolution, specifically between patients/families and providers."

4)    Neefjes V. Can mediation avoid litigation in conflicts about medical treatment for children?

Abstract:
"Conflicts between parents and clinicians about medical treatment for seriously ill children have been litigated in the courts of England and Wales for many years. Whilst the value of applying to the court lies in the resolution of an otherwise intractable conflict, litigation does have disadvantages such as the length of time before a conclusion is reached, the financial costs and the adverse effects of an adversarial process on the relationship between parents and clinicians. 
It is not surprising therefore that especially after highly contentious cases questions are asked how to avoid such litigation in future.
Whilst judges, clinicians, academics and parents agree that improved communication between clinicians and parents could avoid future litigation, research outlining if and to what extent better communication will avoid future litigation is lacking.
This study aimed to investigate the reasons why parents disagree with their clinicians in cases reaching the court and to estimate the number of cases in which mediation might have resolved the conflict and avoided litigation. 
Eighty-three cases regarding medical treatment decisions for children initiated either by an NHS Trust or Local Authority and reported between 1990 and 1st July 2022 were analysed.
The analysis found that the three main areas of contention are different value judgments, factual areas such as the health of the child, their quality of life or burden of treatment and relational issues, i.e. loss of trust. More than half of the cases are estimated not to have been preventable by mediation because either no conflict existed (n=13) or the parental decision was based on strongly held, mostly faith-based, views unlikely to be open for discussion (n=31). 
The study concludes that the potential of mediation to resolve clinician-parent conflicts and thus avoid litigation may be more limited than hoped for."
 

5)    Henriksen J. "Futility" Policy Revision: Addressing Power and Promoting Fairness

Abstract:
"In the United States, a powerful emphasis on individual autonomy and the patient as consumer has influenced the way clinicians offer choices to patients. More than a quarter of ethics consultation requests we receive involve conflicts where clinicians describe feeling pressure to provide, or continue to provide, requested treatments even when they believe those treatments will not help or may be harming the patient. Many U.S. healthcare institutions have developed policies to guide responses to conflicts that arise between clinicians and patients/families about interventions of disputed benefit.
In our hospital system, the Ethics Program is responsible for this policy. In undertaking a revision of the policy, we uncovered that overall, clinicians felt unsupported by the institution and so were less willing to utilize the policy process, choosing instead to acquiesce to patient/family requests for interventions that the clinicians believed to be ineffective or harmful. Additionally, we found that across the organization, the policy had been invoked for patients with marginalized identities at a rate disproportionate to the general patient populations served in our acute care settings. These findings led us to further consider the policy through the lens of power and fairness.
This presentation will frame the ethical tensions addressed in such policies in terms of expressions of power, potential for bias and justice. It will then describe practical approaches and steps we used in revising the policy. The intention was to strike a balance between supporting clinician integrity and professional judgment and honoring patient values and preferences about what goals they judge to be worth pursuing. We will encourage group discussion to learn how other healthcare systems address power imbalances in conflicts around interventions of disputed efficacy."

Bouthillier M.-E., Marckmann G., Metselaar S., Ritzenthaler D., Schildmann J. The role of clinical ethics consultation in requests for assisted dying

Wasson K., Molewijk A.C., Stolper M. Training and assessing ethics support trainees/staff: examining the rationale and practice of two different simulation methods

Dunsford J. and Simpson C. The Aggressive SDM: Clinical Ethics Consultation at the Intersections of Safety, Vulnerabilities, and Best Interests

Al Sinawi H., Al Mandhari Z., Khamis F. Resolving Ethical Conflicts in Multicultural Settings: A Structured Framework for Healthcare Professionals

1)    Ochasi A. Mandela the Ethicist: Introducing the NEMAS Transformative Mediation Framework for Clinical Ethics Consultations

Abstract :
"Ethics consultants are tasked with resolving uncertainty or conflict regarding value-laden concerns that emerge in clinical situations. As such, they assume various roles in the process, with their primary roles often being those of negotiator, mediator, or arbitrator. While acknowledging the value of these methods of conflict resolution, their inherent limitations call for a revised approach. This paper introduces the NEMAS framework (Neutrality, Empowerment, Mutual Recognition, Addressing Power Imbalances, and Shifting from Positions to Interests) for clinical ethics consultations drawn from Nelson Mandela's transformative mediation during the Burundi Civil War. In transformative mediation, the mediators empower the parties to resolve their conflict and encourage them to recognize each other's needs and interests. The complex dynamics of clinical ethics consultations often mirror the challenges in high-stakes conflict mediation in the larger society, where trust, inclusion, mutual understanding, and recognition of each other's perspectives are critical. Mandela's approach in resolving the decade-long conflict between Hutu and Tutsi factions showcases the power of impartiality and inclusivity in fostering trust and collaboration that was pivotal in brokering the Arusha Peace Accords in 2000.
This paper argues that similar dynamics emerge in clinical ethics consultations, particularly in emotionally charged cases involving ineffective (futile) treatment at the end-of-life or complex treatment decisions. As facilitators, ethicists like Mandela must ensure that all stakeholders - patients, families, and the medical team feel heard and valued. Mandela's emphasis on neutrality, empowering marginalized voices,  and addressing power imbalances aligns with the ethicist's responsibility to recognize patient autonomy while balancing clinical realities. Furthermore, Mandela's ingenious approach of shifting discussions from rigid positions to underlying interests offers a valuable tool for ethics consultations. By diffusing the tensions and guiding parties to focus on shared values such as dignity, quality of life, and compassionate care, ethicists help the parties transform their fractured relationship and agree on mutually acceptable solutions."

2)    Kreitmair K. Empathic AI meets Hegel -- The Perils of Off-Loading Clinical Ethics Consultations onto AI Agents 

Abstract:
"Generative large-language models such as GPT4 are being adopted as 'conversational agents' or 'AI agents' in clinical encounters. NVIDIA, for instance, has partnered with Hippocratic AI to develop so-called 'AI nurses' who, for less than nine dollars an hour, talk to patients about their concerns around congestive heart failure, chronic kidney disease, hospital discharge, medication, and pre-operative procedures. This material is not transmitted in a neutral, informational manner. Rather, these AI agents are instances of so-called empathic AI, programmed to mimic human personalities and conversational styles. NVIDIA's AI agents, for example, are described as 'building rapport', 'expressing empathy', and 'getting to know the patient as a person'. At some point, we might imagine, conversational agents could take over the work of clinical ethics consultants. Technically, there is no reason such 'AI agents' would not be able to scour the bioethics literature for germane insights, comb data from electronic health records and prior ethics consultations, incorporate relevant case or statutory law, and provide 'empathic' and 'compassionate' recommendations directly to patients.
I argue that the use of conversational agents in clinical ethics is highly problematic. My argument is based on the claim that essential to good clinical encounters is the Hegelian concept of recognition. Recognition is 'a process in which a subject 'takes' another subject as a subject'. It is the existential action of appreciating another entity as a normative agent. In my argument, I show that clinical encounters, including clinical ethics encounters, require this existential action to fulfil conditions such as trust, respect for autonomy, honesty, and caring, that are essential to good clinical encounters. I further describe that the capacities necessary for recognition, namely voluntariness, capacity for consciousness, and mutuality are all absent in conversational agents. Consequently, I conclude that clinical ethics consultations should never be offloaded onto AI agents."

3)    Khan J. Enhancing conflict resolution: the role of cultural competence in medical interpretation during complex patient discussions

Abstract:
"Effective communication in complex medical care often requires medical interpreters, especially in multicultural settings. Cultural competence is essential also for healthcare ethics committees (HECs) when managing conflicts that arise from miscommunication or differing cultural values between patients and healthcare providers. At our tertiary care hospital in the United Arab Emirates, interpreters and our HEC bridge cultural and linguistic gaps during sensitive discussions, such as delivering bad news and goals-of-care conversations, sometimes towards end of life. This presentation recapitulates preliminary findings for a study done at our hospital around the cultural competence and emotional intelligence of medical interpreters and how these attributes contribute to conflict resolution and ethical decision-making.

The presentation will discuss pre-liminary findings from a mixed-methods study at CCAD, involving surveys and semi-structured interviews with medical interpreters. While interpreters generally demonstrate strong communication skills, we hypothesize that gaps remain in their training, particularly around handling emotionally charged situations and intercultural tensions.

Through the lens of clinical ethics and conflict resolution, the presentation will propose strategies for improving interpreter training. These strategies emphasize enhancing cultural sensitivity, emotional intelligence, and conflict mediation skills, all of which HECs can use to prevent or resolve ethical conflicts. The study also highlights the need for continuous professional development and a supportive environment for interpreters to manage the growing complexities of multicultural healthcare.

By addressing the intersection of HEC, cultural competence, and conflict resolution, this presentation aims to contribute to a more equitable and sustainable healthcare system, aligned with the goals of clinical ethics and patient care."

4)    Filleul A. A living ethics lab in a rehabilitation hospital: Concept and initial development  

Abstract:
"Background: Rehabilitation hospitals faced a wide range of ethical issues, such as the equitable allocation of resources to meet diverse patient needs or managing the opioid crisis in chronic pain management. These situations involve value conflicts and lead to patient frustration and clinician moral distress, contributing to staff retention problems. In addition, administrators and clinicians lack the training and resources to help them make informed ethical decisions.

Aims: LEViER is an innovative living ethics lab aimed at identifying ethical issues in rehabilitation and creating practical, actionable solutions. This project takes place at the Institut de réadaptation Gingras-Lindsay-de-Montréal (IRGLM), a major rehabilitation hospital.

Theory: The project is grounded in the concept of "living ethics," a novel stance that prioritizes dialogue and collaboration. Living ethics encourages open discussions about ethical issues, focusing notably on collective and constructive problem-solving and action.

Methods: This presentation will present the overall concept of the LEVIER program and the results from phase 1, where semi-structured interviews and focus groups with rehabilitation administrators were conducted to identify and categorize the key ethical issues they face. These findings have laid the groundwork for phase 2, which is currently underway. This phase features participatory workshops where administrators, clinicians, patients, and their families collaborate to co-create practical solutions addressing real-world ethical issues and informing policy development. Looking ahead, phase 3 will pilot test these solutions at the IRGLM, with real-time feedback helping to refine and ensure their effectiveness and sustainability.

Discussion: LEViER innovates by incorporating the perspectives of all stakeholders involved in rehabilitation care, with the aim of developing more ethically sound, contextually relevant and innovative solutions. This builds from previous like-minded efforts to propose dynamic and adaptable institutional framework to enhancing staff well-being and quality of patient care through collaboration."
 

5)    Romero M. and Eggert N. Is narrative ethics a tool for resolving conflicts within health care ethics bodies?

Abstract:
"Narrative is now recognised as a tool to support carers in the face of daily challenges and to help patients cope better with their illness. In particular, it is used as a means of 'prevention and resilience against burn-out among carers' (Gateau V., 2022), as well as a 'prophylactic treatment' (Bommier C., Tudrej B. V., Hervé C., 2019).  for their suffering. For patients, recounting their experience of their illness promotes a process of 'empowerment' (Seret-Bégué D., 2020).  by giving value to their stories. More generally, narrative is useful in situations marked by upheaval, such as during the COVID-19 pandemic (Fleury C., Gateau V., 2022). But if narrative benefits carers and patients, could it also be an asset in clinical ethics consultations and ethics committees? Indeed, with its existential, hermeneutic and ethical functions (Ricoeur, P., 1990, Charon, R. 2015, Pierron, J.-P., & Chvetzoff, G.,2021), narrative could help to prevent and resolve conflicts of values within the medical teams that call on these bodies. However, how can narrative be integrated into these deliberations, where objectivity takes precedence over meeting the patient's needs? Who is responsible for telling the story, and on whose behalf? Is it possible to construct a collective narrative within these bodies to better represent the different perspectives? The aim of this contribution is to examine the interests, limits and conditions of possibility of using narrative ethics in the context of deliberation in healthcare."

1)    Eijkholt M. Including patients in ethics support! When would perceptions about harm and risk justify reasons not to include patients in HEC?
2)    Bryant P. Treatment over Objection in Non-Psychiatric Facilities: Toward an Ethical Standard
3)    Aleksandrova-Yankulovska S. Ethical aspects of fertility preservation for specific patient groups and their applicability in clinical ethics consultation 

1)    Schürmann J. The Big Five Revisited: An Evaluation of the Most Frequent Topics in Ethics Consultations after Ten Years of Ethics Support 
2)    Bouthillier M.-E. The perceived needs for standards and certification in clinical ethics practice in Quebec: results from a web-based survey 
3)    Sommerlatte S. Requests for and practice of assisted suicide in Germany. Data and possible implications for clinical ethics consultation 
4)    Shamsi Gooshki E. Implementation of the first centralized clinical ethics consultation and support service in Iran
5)    Teti S. The Effects of Conflict in Ethics Consultation: A Matched Pairs Cohort Study

1)    Chow P.L. How to protect the benefit and maintain justice for migrant workers: the experience in a Clinical Ethics Committee in Singapore 
2)    Liv A. Health professionals’ experiences with uninsured children in Quebec: a qualitative study in pediatric settings
3)    Caci M., Burnens V., Rutz R. Ensuring equity access to healthcare for uninsured patients: a multidisciplinary decision model in a university hospital
4)    Lee H. Integrating Immigrants’ Cultural Traditions in Healthcare Ethics Consultation: Addressing Moral Conflicts in Prenatal Care
5)    Watson J. Ethical Strategies for Improving the Use of Interpreter Services 

Fiester A. Introductory Skills Workshop in Mediation: Learning the Techniques of Conflict Management for Clinical Ethics Consultations

Semler L. Moral Distress: Managing Conflict Within Ourselves and with Others

Payot A., Orr Gaucher N., Dallaire C. Time to Establish Brave Spaces for Clinical Ethics Consultations? Reflection Based on a Framework Implemented in Medical Education

Mukherjee D. Guidry-Grimes L., Berlinger N. Bowen L. Toward Anti-Ableism in Clinical Ethics: Getting Beyond Admiring the Problem

These posters will be available :

• Ali Shah B. Clinicians' Experiences of Obtaining Informed Consent for Research and Treatment: A nested qualitative study from Pakistan
• Al-Maamari A. Navigating Ethical Challenges in Digital Healthcare: Strategies for Responsible Implementation
• Andric V. Ethical concerns surrounding direct-to-patient release of genetic test results in the clinical setting: a scoping review
• Anvar S. Empowered Conversations: Ethical Considerations in Addressing Online Health Misinformation
• Badaiki W. DECLUTTERING THE ETHICS CLOSET: THE IMPACT OF ELECTRONIC HEALTH RECORD SYSTEMS IN CLINICAL ETHICS DOCUMENTATION AND PRACTICE. 
• Bailey M. Lack of Equitable Universal Healthcare Coverage for Federally Incarcerated Individuals in Canada
• Bailey M. Navigating Ethical Considerations Concerning the Care of Uninsured Patients in Canada  
• Bartlett V. Through the Looking Glass: Where Emerging Issues in AI Meet Experience and Insights from Clinical Ethics Consultation 
• Bishop J. Digital Moral Twins, Moral Identity, and Moral Decision
• Boutillier B. PRENATAL WORKSHOP AND SUPPORT GROUP FOR PARENTS OF CHILDREN WHO WILL COME TO THE NICU 
• Chan Z. Ethical Challenges of Robot-Assisted Vascular Surgery: Insights and Implications for the UK
• Chua E. Feeling Strangled: Balancing Best Interests and Public Health in a Breathless and Belligerent Patient
• Cotognini C. and Ruggiero R. How can a health care organization improve patient care while remaining sustainable and effective?
• Cutillo Z. Promoting Positive Childhood Screen Time Usage in the Age of Technology: Ethically Preserving Contemporary Youth Health
• Dzi K. An Umbrella review on the Ageism Older adults face while seeking healthcare services.
• Eves M.  Clinical Ethics Consultation on a Continuum: An Examination of a Coaching approach 
• Fecci A. Ethical Considerations in Research Studies with Transgender and Gender-Diverse Populations
• Furfari K. Colorado's Physician Proxy Law: Lessons in Surrogate Decision-Making and Patient Advocacy
• Hamrouni N. Gendered medical colonialism in Quebec. Bringing the land back in the cultural safety approach to healthcare services 
• Healy E. An Ethical Dilemma: Blood Product Transfusions in Situations of Physiological Futility
• Heistruevers L. From being seen to being heard and understood: Addressing structural vulnerability in the hospital setting
• Huang D. Barriers to Reproductive Autonomy for LGBTQ+ Individual in China
• Hulkower A. Minimizing Bias in Chart Notes through Templates Built for Readily Accessible Health Records 
• Jankowski J. Innovating to Meet Demand: Various Approaches to Personnel and Service Delivery Models in Ethics Consultation 
• Khan J. Cross-border end-of-life decision-making: Ethical considerations in repatriation and cultural sensitivity
• Khoso A. Systemic Challenges to Gender Equality and Pathways to Inclusivity: A Scoping Review and Stakeholder Group Consultation
• Lahfafa A. What factors influence families' bereavement after a death in paediatric intensive care?
• Meudec M. and Marin A. Promoting inclusion and/or combating discrimination in ethics? Conflicts of loyalty in research in Quebec
• Miljeteig I. Increasing Awareness, Skills and Knowledge in Medical Ethics using the ASK ME- tool 
• Monteverde S. Vulnerability and vulnerabilization in healthcare: what can we learn from the Coronavirus pandemic?
• Pilkington B. Realizing Environmental Justice Clinically: A Call to Ethicists
• Rajasegaran K. Disability, uncertainty and quality of life: does culture and religion matter?
• Ravindran N. Empathy Beyond Belief: Navigating Spirituality in Palliative Care Education With Sensitivity And Self-reflection
• Rossetti E. Digitally driven proceduralization of medicine: How clinical ethics can preserve the role of intuition
• Saverio Spiezia F. Ruggiero R IS IT POSSIBLE TO RESOLVE AND PREVENT CONFLICTS? THE KEY ROLE OF CLINICAL ETHICS IN DECISION-MAKING AT THE PATIENT'S BEDSIDE
• Seiler A. Ethical Dilemmas in Phase 1 Clinical Cancer Trials
• Sisti C.The Role of Research Ethics Patient Advocate(REPA) in Advancing Digital Transformation and Artificial Intelligence
• Sourdi M. The Ethical & Epistemic Implications of AI-supported HEC for Schizophrenia Patients
• Streuli J. Navigating decision-making dilemmas in Variations of Sex Development: The shared optimum approach
• Tolo A.K. Heggestad CECC's role in cases involving patients recurring self-harm and suicide attempts
• Zatulovsky Y. and McCann-Davis N. Barriers Behind Bars: A Duty Towards a Dignified Death

1)    MacGregor Brown M. and Nolan V. Using Artificial Intelligence for Proxy Decision-Making  
2)    Starke G. Advancing clinical ethics by developing a Patient Preference Predictor with machine learning: a proof-of-concept 
3)    Amasiadi N. Artificial Intelligence in Pharmacovigilance: Considerations for Clinical Ethics and Consultation
4)    Ruggiero R. and Consolandi M. Clinical Ethics at the Crossroads of Care and Emerging Technologies
5)    Kalogeropoulou C. Navigating responsibility in the age of artificial intelligence (AI): Ethical challenges for healthcare ethics consultation (HEC)

1)    Hirra Hassan Rafi AI in Medicine: Ethical Challenges and the Need for a New Framework for HEC-Response
2)    Van Biesen W. Taylorism and AI as partners in crime to push the care out of Health Care
3)    Schmidt K. W. How can artificial intelligence enhance ethics consultations? Benefits and risks
4)    Hollestelle M. An ethics framework for the transition to an operational learning healthcare system
5)    Annoni, M. Making it Fair: Principlism, Moral Perspectivism, and Ethics Consultation

1)    Surendran S. Ethical challenges around gender-affirming care decision-making among transgender minors, parents and providers
2)    Eichhorn K. Voice Matters: How Gender Affirming Services Builds Agency & Autonomy 
3)    Lim C. Statutory and regulatory requirements, and ethical concerns in the treatment of gender dysphoria
4)    Guidry-Grimes L. Role of Clinical Ethicists in the Shifting Legal Landscape for Gender Affirming Care 

1)    Campbell L. Do clinical ethics services have a role in promoting social justice?
2)    Tabari K. Apprenticeship in Clinical Ethics and Health Justice: Reimagining Fellowship Training for a More Equitable Future
3)    Barned C. If Not Us, Then Who?  The Role of Advocacy & Activism in Healthcare Ethics Practice
4)    Eijkholt M. Nice to have or need to have? Justifications for Healthcare Ethics Consultation (HEC) in tightening resource environments
5)    Ahmad, M. Moral Distress in the United Arab Emirates: Lessons learnt and Moral Resiliency strategies within both Healthcare Ethics Consultation Services and Medical and Nursing Practice

1)    Hug K. Bodily intervention in pediatric oncofertility: Considerations from ethics and human rights perspectives
2)    Francis U. The Clinical Ethics of Contested Illness
3)    Westermair A.L. Justice in End-of-life Care for Persons with Anorexia Nervosa
4)    Beaman L. R. Who is More Worthy? Reimagining Equity and Moral Responsibility in Transplant Patients with Perceived Patient Induced Diseases
5)    Remer D. C. Clinical Ethics in Practice: Ethical Care and Social Justice in Organ Transplantation

1)    Eibling A. Prevalence of refusal to provide emergency contraception to sexual assault victims in Michigan Catholic and non-Catholic hospitals
2)    Schiff J. C., Burgart A. Ethical, Legal, and Social Justice Considerations of Mandatory/Routine Pregnancy Testing in the Emergency Department
3)    Trachsel M. How to deal with the Criterion of Severe Mental Distress for Late Termination of Pregnancy?
4)    Du Peuty C. Justifying late terminations of pregnancy for psychosocial reasons: restoring social justice for women
5)    Calderon Ramirez C.L. The quality of an online democratic deliberation on the COVID-19 triage protocols: results of a Canadian public assessment

Sylvestre P. Réseau d'éthique clinique international francophone (RECIF): comparisons, exchanges and collaborations

Johnston C., Moore K., Sacks B. Including the parents’/family voice in paediatric clinical ethics case consultation - considering best practice

Miljeteig I., Brendbekken A., Solheim H.A. “Be Wise - Prioritize!” Training and Supporting Healthcare Staff Facing Ethical Challenges Due to Resource Scarcity

Chair: Eric Racine, Director of the Pragmatic Health Ethics Research Unit, University of Montreal

1)    Spranzi M. Clinical ethics consultations and somatic treatment for mental health patients: from non-discrimination to de-stigmatization
2)    Barned C. Healthcare Providers’ Experiences with Discriminatory Requests/Refusals from Patients: How Can Ethicists Help?
3)    Chollet M. Towards an anti-racist clinical ethics: rethinking diversity in the hospital setting
4)    Pageau F. Exploratory Research on EDI to Counter Discrimination in Hospital Settings in Canada- A study protocol and preliminary results
5)    Dahlke J. Measuring the intersection of structural discrimination, non-compliance, and implicit attitudes in health care

1)    Frase B. Alone, Vulnerable, and Silent: Navigating Ethical Decision-Making for the Unrepresented Patient
2)    Regel E. Mental Health and Vulnerability: Navigating Cognitive and Socio-Political Challenges in Health Ethics Consultations 
3)    Moisi L. Medical decision-making in critically ill geriatric patients: are we moving from ageism to ableism?
4)    Malbois E. A wolf is in sheeps’ clothing: How Protecting the Dignity of People with Dementia Can Mask Ableism
5)    Olson E. Freak Show: How Monsterization, Isolation, and the Lure of Neurotypicalism Oppress Disabled Adults with Cerebral Palsy

1)    Johnson R.M. Ethical Framework for Offering Fetal Interventions in Fetuses with Concurrent Genetic Diagnosis
2)    Ayoub S. The lived experience of families of children with 22q11 deletion syndrome of the disclosure of the diagnosis
3)    Kondrat A. The Fallacy of Consensus: Reallocating Power in Ethics Consultation 
4)    Faye P.J. Is spirituality in medical education a step towards holistic care or an unwanted avenue for preaching? A systematic review
5)    Gariti A. Normothermic Regional Perfusion in Pediatric Donors - Recommended Guidelines for its Ethical Implementation 

1)    Chobany M. Equity and Access in Healthcare Ethics: Who Gets a Voice in Clinical Consultations?
2)    Izquierdo Martinez L-C. Key components in the professional ethics of sign language interpreters in healthcare contexts: A qualitative study
3)    Santini A. Family on the Frontier: Hospital sanctuary for potential proxies of unauthorized immigrants receiving end-of-life care
4)    Agnaou J. Health Care in Prison: Toward a New Definition of Autonomy?
5)    Johnston C. & Ko D. Ethics support addressing clinicians’ questions about futility and use of finite resources for vulnerable “non-compliant” patients

1)    Streuli J.C. Navigating decision-making dilemmas in Variations of Sex Development: The shared optimum approach
2)    Pannekoek J. But What If - ? Interrogating the Role of Regret in Gatekeeping Gender-Affirming Care 
3)    Rivoire I. Trans identity and access to care: difference as a determinant of trust and trustworthiness in health care and clinical practice
4)    Hamrouni N. Gendered medical colonialism in contemporary Quebec. Bringing the land back in the cultural safety approach to healthcare services
5)    Steininger J., Löffelmann F., Ihrig F. “Flipped Examination Room” - Ascriptions of Vulnerability Between Trans Patients and Their Healthcare Providers 

Agich G., Dawson A., Van Delden H., Matur R., Miljeteig I., Moodley K., Reis A., Shasi-Gooshki E. Interactive Deliberation on WHO’s Clinical Ethics Guidance: A Critical Examination of Draft Content and Key Recommendations

Tilburt J. et al. Situating Ethics Consultation and Overtreatment in Socio-Political Context: Reconciling Power, Plurality, and Principles

Tardif C., Staltari C., Lemieux G. A Workshop on Interdisciplinary Collaboration and Partnership with Indigenous Patients during Clinical Ethics Consultations 

These posters will be available :

• Aebischer G. When you say “conflict of interest”, do you mean “corruption”?
• Anderson D. HEC for Healthcare Buildings: Bioethics Peer Review 
• Baker C. Show Me the Money: Comparing Industry Payments to Physicians and Advanced Practice Clinicians Across Specialties in the USA
• Billstein E. Ethics support staff’s perceptions of patient and parent participation in clinical ethics support services in childhood cancer car
• Blanc S. “Not at home”: insights from case studies on setting preferences in assisted suicide
• Burgess T. South African researchers’ experiences of ethical challenges during COVID-19 and lessons learned for future pandemics
• Buturovic Ponikvar J. The case of organ donation after euthanasia
• de Janon-Quevedo L. Ambivalence While Training Communication of Bad News May Suggest Academic Burnout Among Medical Students 
• Eikamp L.R. Moral Measuring: Thinking or Feeling you know how to measure somethingEves M. Lawst in the Silence: When Lack of Legal Clarity Harms Patients
• Furfari K. Beyond Hierarchies: Rethinking Surrogate Decision-Making with Colorado’s Inclusive Approach
• Giuseppe Staffa A.M. The creation of an Ethical Space within an Italian Territorial Social Health Agency to encourage community welfare
• Hahlweg P. Aid in dying requests: longitudinal processes on diverse levels
• Hassanein M. Navigating Challenges: The Interplay of Identity and Environment in Clinical Ethics Fellowships
• Hassanein M. Provider Preferences and Protected Characteristics: Navigating Requests in a Pediatric Setting
• Horsburgh C. Filling the Gap: Does Clinical Ethics Immersion Continue to Serve the Field? 
• Jaswaney R. Still Good Enough? Considering Disposition Planning for Patients with Eating Disorders and Medical Complexity
• Kennedy A. Proposed Legislation on Physician Assisted Dying in the UK Compared to the International Standards
• Tan M. Quo Vadis? Reforming Practices on Determining Mental Capacity and Identifying Surrogate Decision-Makers in Malaysia
• Kumwenda Mtande T. Exploring the Potential of Moral Community and Moral Dialogues at Bwaila Family Health Unit in Lilongwe, Malawi
• Larocque A. Balancing Risk: Clinicians’ Perceptions and Breast Cancer Screening Recommendation in Quebec
• Moreno-Molina J. Euthanasia in Colombia: Expanding Legal Boundaries and the Role of Clinical Ethics Consultation
• Orfali K. COMPARING THE DECISIONAL ROLE OF SURROGATES FOR INCAPACITATED PATIENTS IN THE US AND MANY EUROPEAN COUNTRIES: WHY SUCH DIFFERENCE
• Pannekoek J. Community and Healthcare Professional Input on the Topic of Normothermic Regional 
• Paulsen W. Midwifery ethics  – more diverse as supposed to be. Do we need a broader approach?
• Pegoraro R. Clinical Ethics Committee’s Deliberation on a Complex Cystic Fibrosis: the Issue of Pregnancy
• Pichardo A. Preventing Financial Toxicity in Healthcare: Organizational & Ethical obligations
• Placencia F.X.  A Cultural Engagement Program for Islamic Parents of Premature Children Eligible for Donor Breast Milk
• Propper R. My Patient Was Dying, And I Did Not Tell Her: Exceptions to Truth-Telling in Pediatric Critical Care
• Pullman D. MAiD (m§edical assistance in dying) in Canada and the Death of Dignity
• Raimondi C. Ethical, Legal and Social Issues in Diagnosis and Prevention of Childhood Melanoma
• Rey Leong J. Shaping the Future of Healthcare Ethics: Insights on Professional Identity and Multidisciplinary Professional Socialisation
• Siddiqui S. ‘Anesthesiologists’ Duty of Care and Questions of Conscience
• Smith A. Newsome Paging Externist: Utilizing Clinical Ethicists in Patient-Engaged Care Planning to Improve Clinical Outcomes Post-Discharge 
• Spriggs K. Lessons from the Holocaust: Patient Advocacy in Nursing Education
• Toader  E. PATIENT WELFARE IN PALLIATIVE CARE: INTEGRATING MEDICAL, MORAL, AND SPIRITUAL DIMENSIONS
• Yan Y. Evidence-Based on End-of-life Decision-making in China for Severe Brain Injury 
• Yeo M. and Gillam L. Dying to be Thin: Confronting ethical questions when young people do not respond to treatment for Anorexia Nervosa

1)    Brendbekken A. Conceptualising costs: prescribing clinicians’ perceptions of opportunity cost in the case of high-cost cystic fibrosis treatment
2)    Brummett A. Principled Conscientious Provision
3)    Warren M. Conscientious Provision of Legal Healthcare Services When An Organization Objects 
4)    Brandeland M. Ethics, Globalization and Healthcare Tourism: A Proposal for Best Ethical Practice Standards in the Care of International Patients

5)    Greer M.L.J., Schiff J. C. Should clinical ethicists “put a pin in it”? The ethics of wearing social justice pins and signs of support on hospital badges

1)    Watson J. Ethics Consultation When Cultures Collide: Setting Expectations for Clinicians and Patients   
2)    Paré-Tremblay A. Patient partnership: an instrument for regaining citizenship
3)    Court S. Patient Participation in Clinical Ethics Support Services: an Impossible Debate
4)    Billstein I. Ethics support staff’s perceptions of patient and parent participation in clinical ethics support services in childhood cancer care
5)    Paré-Tremblay A. Patient Partnership: A Pathway to Reclaiming Civic Belonging

1)    Perron C. Towards a better understanding of medical assistance in dying in Quebec, Canada: The mandate of the CIRAMM 
2)    Marcoux I. Which factors influence the evolution of the use of medical assistance in dying? A scoping review 
3)    Galmiche O. From Polarization to Reconciliation: the Role of Clinical Ethics in Redefining Medical Integrity in the Assisted Dying Debate
4)    Favron-Godbout C. Medical assistance in dying in the context of mental disorders: Co-development of a reflection and discussion guide  
5)    Morrison K. Should health care ethicists provide administrative support/leadership of hospital Medical Assistance in Dying programs? 

1)    Homami S. Navigating Clinical Ethics Dilemmas: A New Framework for Decision-Making 
2)    Farid S. The Need for Healthcare Ethics Consultation in Bangladesh: Addressing Moral Uncertainty and Value Conflicts in a Healthcare System
3)    Dirksen K. Integrity & Sustainability: Exemplifying the Use of an Adapted Clinical Ethics Decision-Making Process in the Hospital Boardroom 
4)    Hofset Larsen B. and Molewijk B. CES staff’s moral challenges related to confidentiality and transparency - needs for moral guidance when offering Ethics Support?
5)    Jameson K. et al. Moral distress in healthcare: Supporting quality of care and staffs' moral empowerment

1)    Fanning J.B. Understanding Treatment Over Objection in Non-Psychiatric Facilities: A Review of the Literature
2)    Ahmad M. Is it ever ethical? Non-disclosure requests from family, healthcare Ethics Consultation (HEC) and Life-limiting diagnoses
3)    Sylvestre P. Preferences Regarding Location of Death in Children with Static or Progressive Encephalopathy: Bereaved Parents' Perspectives
4)    Racine E. A living ethics lab to tackle psychological distress in complex chronic and rare diseases
5)    Zachary Chan S.M. Ethical Challenges in Aesthetic Medicine: Social Media’s Influence in the UK

Crites J. Revising ASBH’s Core Competencies: What the 3rd Edition might mean for Clinical Ethics in the U.S. and Beyond 

Menon S. et al. Clash of the titans: Ethical conflicts when families reject modern medicine in favour of complementary and alternative medicine

Rhodes R. et al. Responding to Moral Complexity 

Bartlett V. et al. You Don’t Know How it Feels: A Reflective Practice Workshop for Healthcare Ethics Consultants

Martisella M. et al. Disagreements regarding gender-affirming care: How can clinical ethicists contribute?

1)    Lemyre S. Toward a better understanding of the use of Medical Assistance in Dying: a qualitative study with international key informants
2)    Lukich N., Oliver S. An integrative and innovative model for MAiD equity: The Ottawa-Champlain Region Experience
3)    Beaudin A. To better understand refusals of medical assistance in dying: a relational ethical approach
4)    Marckmann G., Hirsch A. Beneficence-based ethical obligations in assisted dying
5)    Hahlweg P. Psycho-oncologists’ role in requests for assisted suicide - a qualitative interview study on current state and future directions

1)    Shakhsheer B. Framing Bias in Clinical Ethics Consultation 
2)    Brendbekken A. The multiple roles of a clinical ethical committee: how do ethics education for staff impact ethical consultation requests?
3)    Stout N. Beyond Moral Distress: Understanding Moral Regret in Clinical Ethics Consultation
4)    Levasseur M.C. All caregivers: a case study in implementing a new code of ethics at CHU Sainte-Justine
5)    Gaucher N. Normativity and creativity in clinical and organisational ethics: what are ethicists' opinions?

1)    Fleck. AI, Algorithmic (In)Justice, and the Ethics Consultant: Quo Vadis? 
2)    Chandler L. Innovation for Access of Efficiency? Organizational Responsibilities in AI-Mediated Healthcare Communication
3)    Mollar E. et al. The Role of Research Ethics Patient Advocate (REPA) in Advancing Digital Transformation and Artificial Intelligence

1)    Kelecevic J. Doing the right thing wherever our clients are: a scoping review of clinical ethics support for community service providers
2)    Hall G. Bearing Witness as an Ethical Act
3)    Bartlett V.L. From Fading Myths to Conspiracy Theories: Can Ethicists Bridge Ideals of Physician-Servants and Realities of Corporate Medicine?
4)    Fanning J. B. Resisting Force Through Conditional Thinking
5)    Khamis F. Role of Clinical Ethics in Addressing Equity for MSM Requiring HIV Pre-Exposure Prophylaxis (PrEP) in Non-Western Cultures

1)    Zlotnik Shaul R. Plurality & Power in Paediatric Ethics: A Bioethics Service's 40+ Years of Adapting to Socio-Political Realities
2)    Finder S. Grounding Clinical Ethics Practice in the Clinical as an Inherently Responsive Means for Responding to the Socio-Political
3)    Kekesi-Lafrance K et al. An Advanced State of Irreversible Decline in Capabilities: How Politics Impact Patient Care
4)    Bahmani F. The role of Socio-political issues in the development and function of Hospital Ethics Committees in Iran 
5)    Hendriks M. Navigating Coercion in Medicine: Medical-ethical Guidelines and the Role of Patient Autonomy 

1)    Racine E. Understanding what clinical ethics cases are: Review and perspectives from a Canadian collaborative on clinical ethics methods
2)    Finley-Roy V. Title: Medically assisted dying practices: What role for clinical ethicists?
3)    Blanc S. Advance directives and public support for assisted suicide in a population-based sample of older adults
4)    Martisella M. et al. Disagreements regarding gender-affirming care: How can clinical ethicists contribute?

Brandeland M. et al. Globalization, Healthcare Tourism and Clinical Ethics: Exploring Preventive Ethics Solutions in the Care of International Patients

Abdool R., Fernandes V. Developing an Ethical Framework to Guide Decisions related to Preferential Treatment in Healthcare Organizations

Hotz S. et al. Childrens’ rights in healthcare: How can participation in pediatric and child- and adolescent psychiatric practice succeed?

Memon R. et al. Co-developing a Casebook on Clinical Ethics in Pakistan: Local Stakeholder Engagement and Regional Collaboration