Session: Inequity at the Beginning and End of Life
Mitigating Healthcare Inequities thru Targeted Community Engagement: A Clinical Ethics Team Approach to Improving LGBTQ+ Advance Care Planning
Thursday, September 19, 2024
9:15 AM – 10:15 AM CT
Location: Midway 5 (First Floor)
Abstract: Advance care planning (ACP) is an area of healthcare significantly impacted by structural bias, especially with respect to vulnerable, stigmatized populations like the LGBTQ+ community. A 2021 study by Dickson et al. found that 40% of older LGBTQ+ adults in the Southern U.S. have not appointed a health care power of attorney (HCPOA), and that respondents who were socially isolated, transgender, and younger were even less likely to have completed HCPOA documents. Other studies have yielded similar results, making it clear that ACP rates are disproportionately low in the LGBTQ+ community. Without greater awareness and completion of ACP documents, the LGBTQ+ community can be subject to state laws that only recognize blood relatives as surrogates, not allowing partners, friends, or “chosen family” to be part of vital health care decisions. This talk presents our clinical ethics team’s community outreach and engagement efforts to mitigate health disparities in our community by providing targeted presentations at local LGBTQ+ community events. We will discuss our experiences highlighting: (1) how our team identified and in some instances planned local LGBTQ+ events (2) audience engagement with our presentations, including most commonly asked questions, (3) the overall impact our presentations had on the uptake of ACP, (4) challenges our team navigated and the solutions we implemented, and (5) plans for future programs in the community to improve health disparities around the uptake of ACP. We will conclude by considering the responsibility clinical ethicists have in engaging their local communities in ACP.
Learning Objectives:
After participating in this conference, attendees should be able to:
Understand the disproportionately low rates of advance care planning (ACP) in the LGBTQ+ population.
Describe ways clinical ethics teams can employ a community engagement approach to target improved awareness and uptake of ACP in historically disadvantaged communities.
Consider the professional responsibility that clinical ethicists have to engage in ACP efforts in their local communities.
Anna Goff – Case Western Reserve University and MetroHealth System; Monica Gerrek – Case Western Reserve University and MetroHealth System; Amanda Booher – Summa Health Care
