2025 Colorado Healthcare Ethics Forum Annual Conference

Welcome and introductions.

Shared decision making (SDM) is difficult to implement in mental health practice, but it remains an ethical ideal for motivating therapeutic capacity in patient-clinician relationships; this discrepancy warrants attention from clinical and ethical perspectives. This presentation explores what some clinicians see as obstacles to even attempting SDM with patients with psychiatric disabilities. I identify 4 such obstacles: a patient’s lack of decision-making capacity, a patient’s poor insight, a health care professional’s therapeutic pessimism or personal dislike, and a patient’s or health care professional’s conflicting recovery orientations or goals of care. I argue that each obstacle could be overcome in many cases and that health care professionals, patients, and their caregivers should remain dedicated to attempting SDM in mental health practice.

Objectives:

1. Describe common barriers to shared decision-making in psychiatric care.
2. Analyze how barriers to shared decision-making can be overcome.
3. Discuss ways to understand and enable agency in psychiatric care.

Dr. Guidry-Grimes will be speaking virtually from a conference in Switzerland.

This session will focus on applying and adapting advance care planning approaches to meet the care planning needs of persons with dementia and their families of choice.

Objectives:
1) describe advance care planning approaches for a general population
2) outline key adaptations for persons living with dementia, including assessment of capacity and considerations for supportive decision making
3) practice eliciting values and preferences, including in the context of dementia

Join Elizabeth Moran, Executive Director at The Arc of Colorado, to learn more about Colorado's Supported Decision-making (SDM) Agreement law, what SMD is, and isn't, and 5 things you can do RIGHT NOW to be a part of meaningful systems change that honors dignity of choice and supporting an individual's will and preference. This session will provide a 2024 guardianship-to-supported decision-making case study, with ample time for Q&A and participant discussion.  

Session objectives:

1. Identify less-restrictive alternatives to guardianship/conservatorship.
2. Have a basic understanding of generally recognized best practices of Supported Decision-Making and related agreements.
3. Identify up to 5 things (tools or action steps) they can take RIGHT NOW to incorporate SDM into their practice.

We will discuss and examine the proxy decision-making process, including finding, working with, and terminating a proxy decision-maker, focusing on the related ethical issues. In addition, we will discuss and examine non-proxy surrogate decision-makers and the ethical issues therein.

Objectives:

1. Learn how to conduct a proxy decision-maker appointment process.
2. Learn how to effectively communicate with family members and patients about the process and procedures in both proxy and surrogate decision-makers.

Conference wrap-up. This session will cover the key points covered during the day.