It's Complicated: A Podcast about Healthcare Ethics in Practice

By NSHENMedicine Health & Fitness Education

It's Complicated: A Podcast about Healthcare Ethics in Practice episodes

September 15 Wellness and Trauma Support in the Workplace
Host Marika Warren Guest Rachel Askett, Wellness and Education Lead, Northern Zone DISCUSSION QUESTIONS RESOURCES Canadian Medical Association (CMA): Organizational Wellness https://www.cma.ca/resources/physician-wellness-hub/topics/organizational-wellness Elisseou S. (2023). Trauma-Informed Care: A Missing Link in Addressing Burnout. Journal of healthcare leadership, 15, 169–173. https://doi.org/10.2147/JHL.S389271 Guitar, N.A., Molinaro, M.L. (2017)Vicarious trauma and secondary traumatic stress in health care professionals. University of Western Ontario Medical Journal, 86 (2): 42-43 https://ojs.lib.uwo.ca/index.php/uwomj/article/view/2021 Government of Nova Scotia (2015) Trauma-informed approaches – An Introduction and Discussion Guide for Health and Social Service Providers. IWK Health Centre, Nova Scotia Health Authority, Government of Nova Scotia, May 2015. https://novascotia.ca/dhw/addictions/documents/TIP_Discussion_Guide_1.pdf Mental Health Commission...
24 min
June 03Trust between Health Care Providers
Host
Marika Warren
Guest
Francis Bakewell
DISCUSSION QUESTIONS
How may trust or distrust manifest in the health care setting?
In the patient-provider interaction?
In the interaction between providers?
What are some of the systemic factors that may impact trust relationships between heath care providers?
How might silo’s in health care impact patient care and patient trust in health care?
RESOURCES
Varga AI, Spehar I, Veggeland F, Skirbekk H. Factors influencing trust among colleagues in hospital settings: a systematic review. BMC Health Serv Res. 2025 Jan 3;25(1):16. doi: 10.1186/s12913-024-12159-6. PMID: 39754115; PMCID: PMC11697850.
Sutherland BL, Pecanac K, LaBorde TM, Bartels CM, Brennan MB. Good working relationships: how healthcare system proximity influences trust between healthcare workers. J Interprof Care. 2022 May-Jun;36(3):331-339. doi: 10.1080/13561820.2021.1920897. Epub 2021 Jun 14. PMID: 34126853; PMCID: PMC8669032.
Corbaz-Kurth S, Weissbrodt R, Juvet TM, Hannart S, Krsmanovic B, Salamin Plaschy I, Terrier P. How does trust emerge in interprofessional collaboration? A qualitative study of the significance, importance, and dynamics of trust in healthcare teams and networks. J Interprof Care. 2025 May 15:1-10. doi: 10.1080/13561820.2025.2495013. Epub ahead of print. PMID: 40370201.
Discussion and Resource PageDownload
25 min
March 04Goals of Care Simulation
Host
Marika Warren, NSHEN Ethicist
Guests
David Henderson
and
Sarah Manley
Simulated Patient
Theofani Pitsiavas
DISCUSSION QUESTIONS
Which part of the simulated conversation stood out to you? why?
Were there any aspects of the conversation where you would have liked more information from the patient about their values and preferences?
How might you help patients identify their values and preferences?
How can a conversation like this benefit the patient and his family?
Edward finds it difficult to talk with his wife and kids about his illness and what happens when he dies. Do you think this is common?
Discuss different ways to make people (health care providers, patients and families) more comfortable talking about their values and preferences to help determine Goals of Care and Levels of Interventions. How do we ‘normalize’ these conversations?
Discussion Questions and Resources PDFDownload
54 min
January 27Ethics and Goals of Care
Host
Marika Warren, NSHEN Ethicist
Guests
Lisa Weatherbee, Professional Practice Lead, Palliative Care, NS Health
and
Sarah Manley, Manager of Planning and Development with Palliative Care Network, NS Health
Discussion Questions
DISCUSSION QUESTIONS
How can health care providers prevent their own biases from influencing the patient’s decisions around goals of care?
How might you help patients identify their values and preferences?
In the podcast they talk about the importance of identifying and documenting Goals of Care and Level of Interventions in many different situations and that it should not be limited to end-of-life. In your opinion, when should conversations about Goals of Care take place?
Discuss different ways to make people (health care providers, patients and families) more comfortable talking about their values and preferences to help determine Goals of Care and Levels of Interventions. How do we ‘normalize’ these conversations?
RESOURCES
The resources shared in this podcast were developed collaboratively by the Nova Scotia Health Palliative Care Network, the Integrated Acute and Episodic Care Network, and the Interprofessional Practice and Learning Team. This partnership ensured a comprehensive and inclusive approach to supporting care across settings.
Goals of Care (Clinical Practice Support/ Library Guide) https://library.nshealth.ca/GoalsofCare
[note: this website includes links to resources developed for health care providers and resources developed for patients and families, including the patient education pamphlets individually linked below]
Talking about your Goals of Care and Levels of Intervention: https://www.nshealth.ca/patient-education-resources/2208
Nova Scotia Green Sleeve Information for Patients, Families, and Substitute Decision-Makers https://www.nshealth.ca/patient-education-resources/1833
Conversations about Serious Illness (Clinical Practice Support/ Library Guide) https://library.nshealth.ca/SeriousIllness
Palliative Care (Clinical Practice Support/ Library Guide)
https://library.nshealth.ca/PalliativeCare
Goals of Care Discussion Qs and ResourcesDownload
26 min
December 09, 2025Ethics and Psychedelics Research and Regulations
with
Host, Andrea Frolic
and special guest
James Downar, MDCM, MHSc, FRCPC
DISCUSSION QUESTIONS
What surprised you about psychedelics research and its potentials in treating end-of-life patients’ psychological distress?
Dr. Downar describes several challenges associated with conducting research with psychedelics for treatment of psychological distress in end-of-life patients. Do you think that the regulatory barriers to research on psychedelics are ethically justifiable?
Do you think it is morally imperative to be more risk tolerant when it comes to making psychedelics accessible to end-of -life patients as a way of treating psychological distress?
RESOURCES
Kratina S, Lo C, Strike C, Schwartz R, Rush B. Psychedelics to Relieve Psychological Suffering Associated with a Life-Threatening Diagnosis: Time for a Canadian Policy Discussion. Health Policy. 2023;18(4):134-142. doi:10.12927/hcpol.2023.27048
Watt CL, Downar J. Whither palliative care. Curr Oncol. 2019;26(3):164-165. doi:10.3747/co.26.4803
Podcasts: Psychedelics: Is it time to change your mind… The Critical Care Commute Podcast. https://podcasts.apple.com/ca/podcast/psychedelics-is-it-time-to-change-your-mind-with-dr/id1651920943?i=1000715746659
Ethics and Psychedelics Research Discussion Qs and ResourcesDownload
27 min
October 24, 2025 Working with Patients and Substitute Decisions-Makers (SDMs)
An Education Guide for Nova Scotia Health Team Members
with
Marika Warren, NSHEN Ethicist
and
Amanda Porter, Ethics Collaboration Team
Education guide for staff: Working with Patients and Substitute Decision-makers: Home – Working with Patients and Substitute Decisions-Makers (SDMs) – LibGuides at Nova Scotia Health
Patient and family guide: Making Health Care Decisions for Someone Else: Acting as a Substitute Decision-Maker (SDM) | Nova Scotia Health
Ethics Nova Scotia Health’s Library Subject Guide: Accessing Ethics Support – Ethics Nova Scotia Health – LibGuides at Nova Scotia Health
15 min
September 05, 2025The Context of MAiD in Quebec and Ethical Issues Arising
With
Host, Andrea Frolic
And special guests
Marie-Eve Bouthillier and Delphine Roigt
DISCUSSION QUESTIONS
In 2024, Quebec introduced legislation that allow for advance request for MAiD. The legislation is narrow in scope. You can only enact an advance request for MAiD if you are diagnosed with an illness that is known to lead to incapacity. Moreover, the request is only eligible for the condition it was intended for.
It is mentioned in the podcast that a quarter of Quebec’s population are currently without a family physician and that there are ongoing issues with access to care in general. How would you approach the issue of prioritization with regards to people’s access to care for treatment of illness and access to MAiD?
Ethical concerns associated with advance requests for MAiD include issues around decisions to activate a person’s advance request, issues around resource allocation, and issues around conscientious objection. What do you see as the most pressing ethical issues with advance request for MAiD? Why?
In your opinion, how should situations be managed when a patient’s advance request for MAiD is activated and the patient (who no longer has capacity for health care decision-making) manifests refusal?
RESOURCES
Canadian Medical Protection Association (CMPA). Updated Québec MAID legislation. October 30, 2024. https://www.cmpa-acpm.ca/en/news/2024/updated-quebec-maid-legislation [website accessed May 13, 2025]
Government of Quebec. Advance request for medical aid in dying. https://www.quebec.ca/en/health/health-system-and-services/end-of-life-care/medical-aid-in-dying/advance-request-medical-aid-dying [website accessed May 13, 2025]
Variath, C., Peter. E., Cranley, L., Godkin, D. Health care providers’ ethical perspectives on waiver of final consent for Medical Assistance in Dying (MAiD): a qualitative study. BMC Medical Ethics, 23,8 (2022). https://doi.org/10.1186/s12910-022-00745-4
Discussion Guide – PDF
27 min
August 27, 2025Ethics and Harm Reduction – Addiction Medicine and Case Discussion
with
Host, Amanda Porter
Special Guest, Dr. Thomas Brothers
DISCUSSION QUESTIONS
Dr. Brothers mentions that harm reduction approaches have not historically been incorporated in medical education. What might be some of the reasons for this?
Why do you think there is a difference in the standard of care in the community setting compared to in the acute hospital setting with regards to harm reduction for people who use drugs?
Why do you think that stigma persists in healthcare?
RESOURCES
Brothers, T., Mosseler, K., Kirkland, S., Melanson, P., Barret, L., Webster, D. (2022) Unequal access to opioid agonist treatment and sterile injecting equipment among hospitalized patients with injection drug use-associated infective endocarditis. PLOS ONE, 17(1): e0263156. https://doi.org/10.1371/journal.pone.0263156
Knaak, S., Romie, C., Mercer, S., Stuart, H.: Harm Reduction, Stigma and the Problem of Low Compassion Satisfaction: Tensions on the front-lines of Canada’s opioid crisis. Journal of Mental Health and Addition Nursing. Vol 3 (1) , May 2019. https://utppublishing.com/doi/abs/10.22374/jmhan.v3i1.37
McKay M., Coldwell, M., Graham, S., Upham, K.: Harm Reduction Position Paper. Doctors Nova Scotia (2023) harm-reduction-position-paper2023.pdf
Websites:
Addictions Medicine Consult Service : https://mha.nshealth.ca/en/clients-and-providers/resources-providers/addictions-medicine-consult-service [accessed May 12, 2025]
Canadian Centre for Substance Use and Addiction: Lived and Living Experience | Canadian Centre on Substance Use and Addiction [accessed March 17, 2025]
Nova Scotia Health: What is Harm Reduction. Harm reduction | Nova Scotia Mental Health and Addictions [accessed March 17, 2025]
Harm Reduction-Case Discussion Resource PageDownload
27 min
June 18, 2025Ethics and Harm Reduction – A providers perspective.
with
Amanda Porter, Host
and
Dr. Tiffany O’Donnell, Family Physician, Wije’winen Health Centre
DISCUSSION QUESTIONS
Do you think there is a moral difference between providing people who use drug with a safe supply of drugs and providing them with clean needles and a safe space to inject drugs? Why/why not?
A lot of effort has gone into addressing stigma associated with substance use disorder, including efforts to make people look at it as a health condition and not a moral failure. Yet, stigma towards people who use drugs persist.
Why do you think that is the case?
Can you think of different ways to address stigma associated with substance use disorder?
RESOURCES
Canadian Centre for Substance Use and Addiction:Lived and Living Experience | Canadian Centre on Substance Use and Addiction [accessed March 17, 2025]
Jonson, B. Changing Her Tune. DoctorsNS Magazine, Vol 3 (2), June 2023, p16-17. https://doctorsns.com/news-events/doctorsns/archive/2023-06-01
Jonson, B. Dr. Tiffany O’Donnell takes a new approach to addiction medicine. DoctorsNS, Blogpost, August 2023. https://yourdoctors.ca/blog/health-care/dr-tiffany-odonnell/
Knaak, S., Romie, C., Mercer, S., Stuart, H.: Harm Reduction, Stigma and the Problem of Low Compassion Satisfaction: Tensions on the front-lines of Canada’s opioid crisis. Journal of Mental Health and Addition Nursing. Vol 3 (1) , May 2019. https://utppublishing.com/doi/abs/10.22374/jmhan.v3i1.37
McKay M., Coldwell, M., Graham, S., Upham, K.: Harm Reduction Position Paper. Doctors Nova Scotia (2023) harm-reduction-position-paper2023.pdf
Nova Scotia Health: What is Harm Reduction. Harm reduction | Nova Scotia Mental Health and Addictions [accessed March 17, 2025]
27 min
May 06, 2025 Harm Reduction and Front-Line Healthcare Workers
with
Amanda Porter, Host
and
Alana Weatherbee, Program Manager Northern Healthy Connections Society
This episode is the first in our Harm Reduction series, following our 2024 conference on Harm Reduction.
Harm Reduction Resource PageDownload
28 min

About It's Complicated: A Podcast about Healthcare Ethics in Practice

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A podcast discussion on the latest healthcare ethics issues in practice with guest speakers.

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It's Complicated: A Podcast about Healthcare Ethics in Practice

It's Complicated: A Podcast about Healthcare Ethics in Practice episodes

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