CORE Network Activities

Two working groups have been formed around issues seen by the vast majority of members as pressing strategic issues for the CORE Network. The first of these is the Working Group on Ethics-Related Accreditation Standards for Healthcare Organizations. This working group is co-chaired by Jonathan Breslin and Christine Harrison. Its purpose is two-fold: to support CORE Network members preparing for healthcare organization accreditation; and to help provide leadership at a national level re: ethics-related accreditation standards.

The second CORE Network working group, co-chaired by Linda Wright and myself, is the Working Group on Professionalization/Credentialing of Bioethicists. We are linking with other groups, nascent and long-standing, in Canada and the United States to investigate the potential benefits and demands of pursing standards of healthcare ethics practice, accreditation of bioethics training programs, and professional credentialing and, ultimately, regulation of the role of practicing healthcare ethicist.

Another potential CORE Network working group would focus on developing a draft policy to address the ethical challenges faced by JCB-affiliated health care organizations regarding decision-making involving patients who are uninsured. Karen Faith and Sally Bean have begun this important work at Sunnybrook Health Sciences Centre, and invite CORE Network members to join them.

CORE Network members are also lead or have links to a number of interest groups. The Mental Health Ethics Interest Group, chaired by Bob Parke, is engaging in a much needed focus on often neglected ethical issues arising in mental health care and research. The Narrative Ethics Interest Group — where "the story is the unit of basic understanding" — has been providing opportunities to explore and create personal and professional narratives to enhance self-reflective practice. This interest group, led by Marcia Sokolowski, is currently reorganizing to include not only the sharing and writing of narratives, but also discussion of narrative theories and the value of narrative in ethics education. The JCB Research and Education in Research Ethics (RE²) is led by Ross Upshur for those with an active interest in research ethics.

Other projects underway include an article providing an update on, and critical appraisal of, the capacity-building Hub-and-Spokes Strategy (HSS) for ethics service delivery, looking back over the past 5 years of its customization and implementation across several JCB and other healthcare organizations. The lead author on this paper is Debbie Rolfe and co-authors include Bioethicists who have built their ethics programs around the HSS.

CORE Network members have also expressed considerable interest in a short-term project on informed decision-making, along with the related topics of capacity assessment and substitute decision-making. This project, still to be formally initiated, would support CORE Network members in sharing, updating or expanding their knowledge regarding consent and capacity law, ethical standards and good practices in Ontario.

Other areas for further development include: better integrating and supporting members whose work is primarily in organizational ethics or research ethics; defining and evaluating ethics program quality or effectiveness; creating specialty topic core curriculum modules for ethics committee/forum members and staff in healthcare organizations; producing a comprehensive evaluation strategy for all components of, and participants in, the JCB Academic Fellowship; assessing CORE Network members' needs, interests and potential contributions regarding continuing professional development (look for a SurveyMonkey questionnaire by Jonathan Breslin, coming soon); and enhancing collaboration locally (e.g., within LHINs) and nationally (e.g., with Accreditation Canada, Canadian Bioethics Society).

The newly named CORE Network has come a long way in 10 years — from a small group of clinical ethicists meeting once per month to a large group of healthcare ethicists and fellows engaging in multiple roles and projects on a weekly — sometimes daily — basis. Says Ross Upshur, "I'm delighted with the revitalization and branding of the CORE Network, which promises to be a motivating energy central to our Bioethics Collaboratory."