Novato Community Hospital Clinical Neuroethics Initiative

Neuroethics is a young field that considers the rights and wrongs of treatments and procedures involving the human nervous system. Currently, neurological disease affects about 1 in 6 Americans. Patients and hospital staff dealing with neurological issues account for the largest subset of ethical consultation requests in Sutter Health’s Program in Medicine and Human Values (PMHV).

PMHV’s Clinical Neuroethics Initiative has served as a leader in neuroethics, taking the field from laboratory to bedside.

Projects include:

• Improving Communication after Stroke — This project invited family members and patients in the Stroke Intensive Care Unit to complete an anonymous survey asking how they assess their doctors’ communication, including the facts, manner and emotional delivery of information. The goal was to design educational tools to help doctors evaluate and improve their own communication skills when treating severely brain-injured patients.
• Improving Care for ALS Patients — ALS patients were invited to complete a survey examining their attitudes toward end-of-life decision making. Goals were to help doctors establish better communication, incorporate end-of-life decisions into care discussions and to more effectively help patients make informed, values-driven decisions.
• Improving Communication for Neurological Patients — Working collaboratively with ALS, stroke and dementia specialists, PMHV staff sought to devise a tool that will empower doctors to determine the wishes and preferences of neurologically-injured patients. This enabled doctors and other staff to respect patients’ right to participate in making healthcare decisions for themselves.
• Neurotechnology Review and Ethics Service — This effort tapped the experience of Sutter Health clinicians who specialize in neurorehabilitation, neurosurgery and ALS. By combining expertise in science, technology and neuroethics with the clinical implications of new technologies, the service recommended approaches that address potential conflicts of interest and other ethical dilemmas that arose with neurotechnology cases. This service was unique and served as a model within Sutter Health and beyond.