Mt. Ascutney Hospital and Health Center

VT Ethics Network

A recent forum on medical ethics raised complex questions, and an oft-repeated piece of advice - to use Advance Directives to take charge of your healthcare.

Mt. Ascutney Hospital and Health Center's Ethics Committee sponsored the daylong forum Jan. 30 to look at some of the moral dilemmas of healthcare. One helpful solution, Advance Directives, was recommended again and again.

That legal document outlines a person's wishes about medical treatment near the end of life or in certain life-threatening circumstances. Would he or she, for instance, want to limit the use of machines to sustain life if he or she were in a coma and recovery wasn't expected? When that's left unclear, family members can be bitterly divided.

"Advance Directives can be awfully important,'' said Margo Howland, an attorney from Windsor who participated in the forum. "They can spare your loved ones a lot of anguish.''

Dr. William Palmer, an internist at the hospital, and Judy Jones, a nurse who works in the Staff Education Department, gave a presentation about disagreements that can arise about whether to resuscitate a patient when prospects for recovery are poor. "The ultimate choice is the patient's,'' said Jones.

But what if the patient can't express his or her wishes anymore? "Advance Directives can save a lot of grief,'' said Dr. Palmer.

In the opening session, the Rev. Judson Pealer of St. Paul's Church in Windsor gave a wide-ranging overview of justice in healthcare. He raised questions designed to provoke thought and conversation. "How do you have justice (in allocating healthcare) when there's just not enough to go around?'' asked Pealer. "We're coming to a place as a society where major decisions have to be made.''

Later, Dr. Alicia Zbehlik led a discussion about "futile care,'' treatment when there is no hope for improvement of an incapacitating condition. "Care is never futile, but some interventions might be,'' she said.

Jill Lord, Director of Patient Care Services at Mt. Ascutney, welcomed the two dozen attendees and made a presentation on ethical decision-making. Margo Howland led the final session, on the need for Advance Directives and how to fill them out.

Area hospitals, including Mt. Ascutney Hospital, distribute Advance Directives forms. The Vermont Ethics Network (802) 828-2909 provides information about a state registry for Advance Directives and has forms online at In New Hampshire, the Foundation for Healthy Communities (603) 225-0900 has information about Advance Directives online at