Understanding and Implementing Informed Nondissent in the ICU

Third talk is session:

Informed nondissent has been officially endorsed by SCCM and ATS as an ethically appropriate model of decision-making in the ICU under specific circumstances.  However, many ICU clinicians do not fully understand this model and therefore do not use it or use it incorrectly.  Dr. Kon will discuss the rationale and theory behind informed nondissent, including a detailed discussion of how and when to employ this important tool at the bedside.  He will explain some of the major pitfalls clinicians face when employing informed nondissent, and necessary steps to avoid these problems.  Because there is significant risk of inappropriately limiting patients’ and family members’ ability to actively participate in decision-making when employing informed nondissent, Dr. Kon will articulate this risks and provide key steps necessary to ensure patients and family members are supported appropriately in the decision-making process.

Alexander Kon, MD, HEC-C, FCCM, is the Medical Director of the PICU at Community Children’s and Professor of Pediatrics and Bioethics at the University of Washington, past Chair of the SCCM Ethics Committee, past President of the American Society for Bioethics and Humanities, lead author of the SCCM shared decision-making policy statement, and a prolific author in the area of decision-making in the adult and pediatric ICU settings.  Dr. Kon first introduced the informed nondissent model in the medical literature in 2008 and has written extensively on this topic.