Day 1 | Thursday, May 20, 2021
Times shown are Eastern Daylight Time
What Every Great Guardian Should Know About Health Care Decision-Making, Parts 1 and 2
Making decisions about a person’s health care is often one of the most challenging responsibilities a guardian may face. The role of the guardian to make, or assist a person to make, health care decisions ranges widely from scheduling routine appointments to authorizing serious surgical procedures and end-of-life decisions. While the definition of a guardian’s roles and responsibilities varies from one state to the next, guardians generally have the broad responsibility and authority to make independent decisions regarding the care, services, and treatments for persons in their care, and are expected to access all of the necessary information available to ensure those decisions are informed. The workshop presenters will explore the guardian’s role in making health care decisions for a variety of populations, and will provide an overview of existing laws, ethics, standards, practices, and tools that offer critical guidance in this area.
1:35 pm – 1:45 pm | Opening Remarks
1:45 pm – 3:15 pm | Part 1
The Ethics of Health Care Decision-Making As A Guardian
Michael Jenuwine, PhD, JD, University of Notre Dame Law School
Generally, guardians are charged by state statute with exercising “substituted judgment” for or acting in the “best interest” of the protected persons in their charge. The legal meaning for these concepts is most often not clearly understood and, in the context of health care decision-making, they can also be particularly problematic. This session will provide attendees with a general road map for understanding legal and ethical decision-making in the health care arena.
Critical Health Care Decision-Making Considerations for Adults with Intellectual and Developmental Disabilities
Mary R. Ciccarelli, MD, Indiana University
Intellectual and developmental disabilities may involve conditions that impose limitations upon a person’s ability to care for themselves, express themselves, or live independently. Guardians are expected to understand the factors that can contribute to these limits particularly regarding health care choices, and ultimately support them in making their own health care decisions with as much self control and reliance as possible. This session will provide attendees with an overview of the health care decision-making needs of persons with disabilities, and offer insights and tools to provide support for the decision-making roles of both the person and the guardian.
3:15 pm – 3:30 pm | Break
3:30 pm – 5:00 pm | Part 2
Critical Health Care Decision-Making Considerations for Adults With Mental Illness
Tracy D. Gunter, MD, Indiana University School of Medicine, Department of Psychiatry
Persons with mental illness who are under a guardianship court order are generally considered to have a level of impaired decisional capacity that interferes with their ability to understand and appreciate the nature and consequences of the decision-making that allows them to reach their own informed decisions. While a person’s functional ability is based on a number of factors, it is important for guardians to understand that decision-making capacity exists on a continuum, is highly contextual, and can be intermittent. This session will provide attendees with an overview of the decision-making capacity of persons with mental illness, appreciation for the roles of the treating doctor and forensic consultant in guardianship matters, and will challenge them to consider alternatives to guardianship in the management of persons with intermittent incapacity.
Critical Health Care Decision-Making Considerations for Aging Adults
Rajarajeswari Majety, MD, CMD, Franciscan Physician Network
Health care decision-making directly impacts the quality of life and quality of care for aging adults, particularly for those who are in hospitals or long term care nursing facilities. The process of making timely, appropriate, and cost effective health care decisions can be challenging in these cases. The role of the guardian in making, or assisting the aging person to make, health care decisions must include understanding and appreciating the nature and consequences of the decisions, including the benefits, risks, costs, and alternatives to any proposed health care in order to reach an informed decision. This session will provide attendees with key content to support health care decision-making for aging persons, and practical considerations for ways to fulfill the role of the guardian.
5:00 pm | Day 1 Closing Remarks