UF Psychiatry presents at UNESCO Chair in Bioethics 13th World Congress

By: Caroline Nickerson

On the week of November 26, Joseph (Joe) E. Thornton, MD, Michael Shapiro, MD, and Caroline Nickerson presented at the UNESCO Chair in Bioethics 13th World Conference: Bioethics, Medical Ethics and Health Law in Jerusalem, Israel.

Michael Shapiro, MD at Bioethics World Congress
Dr. Michael Shapiro speaking on the ethical issues when parents refuse treatment for children under 18.

Dr. Thornton is head of the UF-VA UNESCO Bioethics Unit, Dr. Shapiro is on the Unit’s steering committee, and Caroline Nickerson serves as executive assistant for the Unit. Each year, the UF-VA UNESCO Bioethics Unit hosts the World Bioethics Day Celebration in Gainesville, FL. The UF-VA Unit expresses gratitude to Dr. Russell D’Souza, Chair, Asia Pacific UNESCO Bioethics Network, Australia, for his invaluable assistance in establishing our Unit.

The UF-VA UNESCO Bioethics Unit is one of 210 scattered across five continents. All the Units seek to engage vibrant bioethics discussion across disciplines, bringing in the perspectives of not only medical professionals, but also lawyers, philosophers, and others. Bioethics is a broad field that encompasses issues of right and wrong conduct relating to biology, medicine, health – and the interactions of these fields with the rest of society.

As Director of the UF-VA UNESCO Bioethics Unit, Dr. Thornton attended the pre-conference Unit Directors meeting.  Approximately 50 of the 210 Unit Directors convened to discuss progress of the program and plan for next year.   The program plans to offer Regional Awards for essays, short film and art for the World Bioethics Day competition with special attention to the Student Awards. The UF-VA UNESCO Bioethics Unit with coordinate the North American submissions.  Dr. Thornton also announced that Dr. Catherine Striley from the College of Public Health and Dr. Michael Shapiro has been accepted for membership into the International Forum of Teachers.

Dr. Shapiro, Assistant Professor, Clinic Director of the Child Psychiatry Clinic at the Springhill Health Center, Medical Director of UF Health Child and Adolescent Psychiatry, and Compliance Officer at the UF Department of Psychiatry, presented “Is Parental Refusal to Treat Pediatric Depression ‘Mental Health Neglect’?”

His presentation focused on ethical issues at play when parents refuse treatment for children under 18 with mental health issues. He discussed mental health stigma and state/national laws in the United States, as well as raised the questions posed by the UN Convention on the Rights of the Child and the UNESCO Declaration on Bioethics and Human Rights. Dr. Shapiro also wrote a similar article about the subject for The Conversation.

Regarding the conference in general, Dr. Shapiro commented: “It was really great to attend a conference where the focus was on stimulating thought about our processes and whether medicine is fulfilling its ethical obligations to patients and the profession. I was proud to participate in both making my own presentation and contributing to the discussion of others’ presentations regarding how ethical dilemmas impact patient care. I also appreciated the opportunity to visit Israel for the first time.”

Dr. Joe Thornton at the World Bioethics Congress
Dr. Joe Thornton presenting at the 13th Annual World Bioethics Congress.

In the very last session of the conference (but still with a great turn-out!), Dr. Thornton, Associate Professor of Psychiatry and Chief of Psychiatric Services at UF Health Shands Hospital, presented “Ethics of Psychiatric Assessment to Possess Firearms in the USA.” This presentation was based on research he conducted with Brian Cooke, MD, Assistant Professor at UF Psychiatry, and Rajiv Tandon, MD, Professor at UF Psychiatry. Dr. Thornton framed the deaths and injuries related to firearms as a major public health problem in the USA in the realm of mental health, with suicides and murder suicides from firearms outnumbering homicides from firearms. He discussed the legal context of firearm ownership, as well as the circumstances in which liberty and right to refuse treatment can be abridged for psychiatric reasons. He ended by considering the ethics and knowledge base needed to make medico-legal recommendations for firearm restrictions in the USA.

Dr. Thornton commented “As our unit enters into its 4th year we are able to see more clearly how to expand bioethics training into everyday practice.  A common theme from multiple countries is the importance for trainees to participate in guided discussions of ethics rather than simply attend didactic sessions. “

Caroline Nickerson displays puzzle pieces
Caroline Nickerson holds a blanket displaying the puzzle pieces created in an art therapy project as part of the Christensen Ethics Curriculum.

Caroline Nickerson presented “’Ethics in Psychiatric Practice Curriculum’: The Universal Ethical Principles Regarding Serving Underserved Populations Through Psychiatry.” This presentation focused on the curriculum created by the University of Florida Psychiatry Department, the Sulzbacher Center, and other partners as a memorial to Dr. Richard C. Christensen (Dr.C) and based on his articles. Dr. C devoted his life to serving homeless and other underserved populations through psychiatry; accordingly, this curriculum focuses on the unique ethical issues that can arise when working with these groups. The curriculum, an introduction to this unique branch of ethics for psychiatry residents, was grounded in Dr.C’s attitude toward medicine: “the practice of medicine is a moral endeavor grounded in a covenant of care.” The presentation also shared thoughts on curriculum development and the importance of bringing Dr. C’s friends, family, colleagues, students, and patients together as equal partners to enable a legacy of care to live on and continue to grow. The curriculum has been peer-reviewed and accepted by American Association of Directors of Psychiatry Residency Training (AADPRT). The Christensen project, which encompasses this curriculum, the PEARLS book, and a website, is ongoing.

Caroline expresses her gratitude to UF Psychiatry for allowing her to attend this conference and share Dr. C’s message with an international audience. UF Psychiatry is one of the greatest places in the world!