Dane Gibson
Northern News Services

NNSL (May 14/99) - If a person has a contagious disease, how do you weigh their right to privacy against the health of the population they interact with?

Doctors, clergy, hospital management and social workers are just a few of the occupations that require ethical decisions to be made on a regular basis.

Stanton Regional Hospital Ethics Committee chair, Karen Hoeft, recently returned from Toronto where she attended two ethics related seminars. She is applying what she learned to issues relevant in the North.

"One of our main functions right now is to educate the public about what an ethical dilemma is," Hoeft said.

"For example, does the rights of a person with tuberculosis to remain anonymous outweigh the risks that person poses to the public? It's a debate that is equally applicable to AIDS.

"If you have a limited budget, and you have to choose how long to keep the Emergency Room open, or how many nurses to keep on-call, that raises ethical questions."

Hoeft, who is also the assistant executive director of the Yellowknife Salvation Army, said ethical dilemmas can be as wide-ranging as they are difficult to find common ground on.

"We live in a day and age where TV tells us that hospitals can revive anybody, but reality says under 5 per cent of critically injured people survive CPR," Hoeft said.

"If your heart stops it's usually for a good reason, but there are people who believe if you don't perform CPR, then the treatment wasn't good enough.

"The hard reality is people die, and one of the things ethics tells you is there's no easy answers, there's only competing values."

An issue that's raising ethical questions in Yellowknife is the fact that seniors are more frequently requesting a 'Do Not Resuscitate' order be placed on their medical charts. It's something that is gaining acceptance across Canada.

That means if a person dies of natural causes, doctors cannot hook up machines to prolong life.

"Who makes the ethical decision that your life is no longer worth living -- is it the doctor, the family or the individual? There's a new machine that by-passes your heart and lungs -- so what is death?" Hoeft asks.

"When the patient can no longer make the decision to pull the plug or decide what kind of treatment to administer, then we start getting into advanced health care directives. We're starting to see trends where seniors want to die peacefully and not attached to machines."

Hoeft said the Ethics Committee is bringing in an international speaker from Toronto who will be conducting a seminar, June 7-8, on advanced health-care directives. She said it's just one way the committee -- made up of people such as doctors, pastors, and hospital managers -- to foster open discussion on tough ethical questions.

"We want to create an atmosphere where the people who have to make those choices realize that the choices they make are ethical ones," Hoeft said.

"We're trying to slowly look at these difficult issues piece by piece. The ethics committee doesn't make ethical decisions on specific situations. The people we work with make those decisions so we're trying to ensure everybody sees the bigger picture, and makes ethics a part of their life."