First, Do No Harm Balancing Competing Priorities in Surgical Practice

Size: px
Start display at page:

Download "First, Do No Harm Balancing Competing Priorities in Surgical Practice"

Transcription

1 First, Do No Harm Balancing Competing Priorities in Surgical Practice Annie Leung Shelly Luu Glenn Regehr M Lucas Murnaghan Steven Gallinger Carol-Anne Moulton

2 I have no actual or potential conflict of interest in relation to this presentation. Disclosure Statement

3 A Moment

4 We were doing a laparoscopic colon resection. She [the resident] was mobilizing the sigmoid, which was more fibrotic because of previous surgery. I remember in my mind thinking she s going too fast, I should take over, but I didn t want to because I wanted to give her a chance to get to do it. I was in a stage where my goal was to let the residents do as much as possible (I20) A Moment

5 I remember when I looked at it, before I could open my mouth, I was like crap, that s the ureter. She divided the ureter and you could see it. It was 20 seconds where she was just maybe off the wrong plane and I was trying to give her feedback and 5 seconds where I was getting ready to say here let me show you, but it was too late. (I20) A Moment

6 A Moment and the Decision

7 SchÖn s Reflective Cycle Reflection-on-action Knowing-in-action Reflection-in-action Schön s Cycle of Reflection Donald Schön The Reflective Practitioner: How Professionals Think in Action

8 Constructivist Grounded Theory Semi-Structured Interviews, 39 Surgeons General 18, Neurosurgery 4, Orthopaedic 4, Cardiac 3, Vascular 3, Thoracic 2, Otolaryngology 2, Plastics 2, Trauma 1 Methods

9 Personal Complications errors and/or adverse events Methods

10 Factors that influence intra-operative decisions Methods

11 Analysis: Inductive & Deductive Grounded Theory Professionalism Framework Methods Ginsburg S, Regehr G, Lingard L To be and not to be: the paradox of the emerging professional stance. Med Educ 2003;37:350-7

12 Decision Making feels like

13 ...They all say the patient who is asleep at the time has your undivided attention but they don t... there are time pressures, nursing pressures, anaesthesia...you re not working in isolation. (I17) Decision making feels like...

14 Avowed Unavowed Disavowed Ginsburg s Framework Ginsburg S, Regehr G, Lingard L To be and not to be: the paradox of the emerging professional stance. Med Educ 2003;37:350-7

15 Avowed Patient s best interest e.g. first do no harm ideals of the profession

16 With his [the patient s] cardiac history, I decided a quick operation is a good operation, and didn t let the resident do much. (I22) Avowed

17 Unavowed Unacknowledged Undeclared e.g. time pressure teaching

18 I think the pressure of the clock is distracting and you hurry things along...we know that it is a wrong thing to operate by the clock but we re put in a position where we re in some ways forced to do that. (I1) Unavowed

19 Disavowed Denied, Discouraged, Inconsistent with professionalism e.g. monetary incentives concern for personal reputation

20 There are ones like, well, do I really need this help, do I want to seem like a loser, am I going to call someone? (I25) Disavowed

21 Avowed Unavowed Disavowed Ginsburg s Framework

22 Surgeon: I accept little imperfections because I think that they don t matter and I think that residents obviously have to learn... Interviewer: So you allow for some imperfections in how it looks or how it s carried out but you re monitoring how far it goes away from where it should. The Tension

23 Surgeon: Right, and I wouldn t let someone divide a tumour just let them learn about it, that s not what I mean. Interviewer: So you said you wouldn t let them divide a tumour but you let them divide a ureter. I m being the devil s advocate here. So how does that? The Tension

24 Surgeon: No, what I mean by letting them divide the ureter... I wouldn t let them do that it s just I didn t, like The problem was in that moment everything happened so fast. If I thought hey, there was a chance that she might injure the ureter I guess I did kind of think it but I thought that by coaching here I could avoid it. The Tension

25 Do No Harm vs. Surgical Reality

26 Mindful Practice Epstein RM Mindful Practice. JAMA (9):833-9

27 SLOWING DOWN WHEN YOU SHOULD: The Key to Expert Judgement Patient Safety

28 Surgical Education

29 The Culture of SURGERY You re not supposed to be afraid. You re supposed to be in control. You re supposed to know everything. You re supposed to be able to handle it. (J003) Surgeon as a Performer Jin CJ, Martimianakis MA, Kitto S, Moulton CA Pressures to Measure Up in Surgery. Ann. Surg Jul 20

30 Thank You Jenny Jin Nathan Zilbert Shira Gold Jacob Gallinger Sandra de Montbrun Tulin Cil Doug Buller Ministry of Research and Innovation Early Researcher Award Royal College of Physicians and Surgeons of Canada Medical Education Research Grant University of Toronto Faculty of Medicine Comprehensive Research Experience for Medical Students Summer Scholarship

The possibility of change

The possibility of change The possibility of change Transcript of an interview with Dr. James Orbinski The following is the complete transcript of a Mar. 7, 2008 phone interview conducted by Barbara Sibbald, Deputy Editor: News

More information

UK Moral Distress Education Project Tilda Shalof, RN, BScN, CNCC Interviewed March 2013

UK Moral Distress Education Project Tilda Shalof, RN, BScN, CNCC Interviewed March 2013 UK Moral Distress Education Project Tilda Shalof, RN, BScN, CNCC Interviewed March 2013 My name is Tilda Shalof, and I'm a staff nurse at Toronto General Hospital in the medical surgical ICU. I've been

More information

MS Learn Online Feature Presentation Medical Self Advocacy: Getting More from Your HealthCare Team Featuring Marion Brandis, MA, RN, BSN

MS Learn Online Feature Presentation Medical Self Advocacy: Getting More from Your HealthCare Team Featuring Marion Brandis, MA, RN, BSN MS Learn Online Feature Presentation Medical Self Advocacy: Getting More from Your HealthCare Team Featuring Marion Brandis, MA, RN, BSN Tom: Hi I m Tom Kimball Tracey: And I m Tracey Kimball, welcome

More information

Strong Medicine Interview with Dr. Reza Askari Q: [00:00] Here we go, and it s recording. So, this is Joan

Strong Medicine Interview with Dr. Reza Askari Q: [00:00] Here we go, and it s recording. So, this is Joan Strong Medicine Interview with Dr. Reza Askari 3-25-2014 Q: [00:00] Here we go, and it s recording. So, this is Joan Ilacqua, and today is March 25, 2014. I m here with Dr. Reza Askari? Is that how you

More information

MUSLIM INNOVATIONS THAT SHAPED THE WORLD

MUSLIM INNOVATIONS THAT SHAPED THE WORLD WA1 MUSLIM INNOVATIONS THAT SHAPED THE WORLD IAE MUSLIM INNOVATIONS THAT SHAPED THE WORLD In this ibook you will find images, videos and a prereading that will help you to familiarise yourself with the

More information

Handouts on CNSC website. Videoconference Event ID: LEARN FROM US 21/05/2015

Handouts on CNSC website. Videoconference Event ID: LEARN FROM US 21/05/2015 LEARN FROM US PERSON DIRECTED OUTCOMES THAT SUPPORT AN INDIVIDUALIZED APPROACH TO SERVICE Thurs, May 28, 2015 Videoconference Event ID: 4380874 Handouts on CNSC website 1 How to submit your Feedback about

More information

Thoughts on Physician Advocacy and Payment Reform with AMA Past-President Andrew Gurman, MD

Thoughts on Physician Advocacy and Payment Reform with AMA Past-President Andrew Gurman, MD Transcript Details This is a transcript of an educational program accessible on the ReachMD network. Details about the program and additional media formats for the program are accessible by visiting: https://reachmd.com/programs/focus-on-public-health-policy/thoughts-physician-advocacy-paymentreform--ama-past-president-andrew-gurman-md/8183/

More information

A Near- Death Experience with Veridical Perception Described by a Famous Heart Surgeon and Confirmed by his Assistant Surgeon

A Near- Death Experience with Veridical Perception Described by a Famous Heart Surgeon and Confirmed by his Assistant Surgeon BRIEF REPORT A Near- Death Experience with Veridical Perception Described by a Famous Heart Surgeon and Confirmed by his Assistant Surgeon Titus Rivas, M.A., M.Sc. Nijmegen, The Netherlands Rudolf H. Smit

More information

IMPORTANCE OF DAILY DEVOTION

IMPORTANCE OF DAILY DEVOTION Life Building Station : How To Keep Daily Devotion : Session I : Importance of Daily Devotion (Quiet Time) 1 SESSION I IMPORTANCE OF DAILY DEVOTION Daily Devotion is a quiet time set aside to be ALONE

More information

Responding to Critical Events: The Human Element

Responding to Critical Events: The Human Element Responding to Critical Events: The Human Element Geri Amori, PhD, ARM, DFASHRM, CPHRM VP Academic Affairs Coverys Disclaimer This presentation is a work product of Coverys Healthcare Provider Education

More information

Spirituality in the ICU. Deborah Cook

Spirituality in the ICU. Deborah Cook Spirituality in the ICU Deborah Cook Critical Illness Triggers.. Existential questions about purpose meaning relationships destiny Spirituality attends to matters beyond the physical where hope, support,

More information

The Arrival S1 M. Devotion Leader. Supply Manager. Site Reporter. Lunch Maker. Crew Roles:

The Arrival S1 M. Devotion Leader. Supply Manager. Site Reporter. Lunch Maker. Crew Roles: The Arrival S1 M T1 W T2 F S2 Welcome To Reach W You chose your destination; you ve planned your route; you ve packed your bags, and your journey has begun. But what lies ahead? Will everything go as planned?

More information

Spiritual Conversations: Its Really Okay

Spiritual Conversations: Its Really Okay Spiritual Conversations: Its Really Okay Richard Brown, M.Div., BCC ACPE Supervisor Director of Chaplaincy Services and Clinical Pastoral Education Carilion Clinic Objectives Spiritual History versus Spiritual

More information

NOT DESIGNATED FOR PUBLICATION BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION CLAIM NO. G JON HARTMAN, EMPLOYEE

NOT DESIGNATED FOR PUBLICATION BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION CLAIM NO. G JON HARTMAN, EMPLOYEE NOT DESIGNATED FOR PUBLICATION BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION CLAIM NO. G300315 JON HARTMAN, EMPLOYEE EXTERIOR SOLUTIONS, INC., EMPLOYER TRAVELERS INSURANCE, CARRIER/TPA CLAIMANT

More information

LEADING WITH CONFIDENT HUMILITY IN THE MIDST OF PARADOX VALUES IN CATHOLIC EDUCATION

LEADING WITH CONFIDENT HUMILITY IN THE MIDST OF PARADOX VALUES IN CATHOLIC EDUCATION DIAMONDS LEADING WITH CONFIDENT HUMILITY IN THE MIDST OF PARADOX VALUES IN CATHOLIC EDUCATION DEBORAH ROBERTSON SENIOR LECTURER, ACU. Leading for mission and identity ABSTRACT The aim of this presentation

More information

Kent Surrey Sussex Patient Safety Collaborative

Kent Surrey Sussex Patient Safety Collaborative Kent Surrey Sussex Patient Safety Collaborative Proposal Paper for Consultation 1 P a g e Introduction This paper explains proposals for the governance, operational structure and initial priorities for

More information

NTR SIGNS OF THE TIMES. Christina M. Puchalski, M.D., O.C.D.S. Spirituality: Implications for Healing

NTR SIGNS OF THE TIMES. Christina M. Puchalski, M.D., O.C.D.S. Spirituality: Implications for Healing NTR SIGNS OF THE TIMES Christina M. Puchalski, M.D., O.C.D.S. Spirituality: Implications for Healing Health care spirituality is the foundation for the health care system. Indeed, spirituality has implications

More information

Ethics. Road map. Outline. Gary W. Oehlert. February 5, Three class sessions on ethics:

Ethics. Road map. Outline. Gary W. Oehlert. February 5, Three class sessions on ethics: School of Statistics University of Minnesota February 5, 2007 Outline Road map Three class sessions on ethics: 1 General 2 Scientific 3 Statistical Full Disclosure These classes draw heavily and extensively

More information

DURABLE POWER OF ATTORNEY/DECLARATION WITH RESPECT TO HEALTH CARE DECISIONS AND POST-MORTEM DECISIONS FOR USE IN CALIFORNIA

DURABLE POWER OF ATTORNEY/DECLARATION WITH RESPECT TO HEALTH CARE DECISIONS AND POST-MORTEM DECISIONS FOR USE IN CALIFORNIA The Halachic Living Will DURABLE POWER OF ATTORNEY/DECLARATION WITH RESPECT TO HEALTH CARE DECISIONS AND POST-MORTEM DECISIONS FOR USE IN CALIFORNIA The Halachic Living Will is designed to help ensure

More information

Coping with Career Burnout: A Physician's Journey through Renaissance Art

Coping with Career Burnout: A Physician's Journey through Renaissance Art Transcript Details This is a transcript of an educational program accessible on the ReachMD network. Details about the program and additional media formats for the program are accessible by visiting: https://reachmd.com/programs/book-club/coping-with-career-burnout-a-physicians-journey-throughrenaissance-art/10161/

More information

Discovering My SHAPE For Ministry CLASS 301

Discovering My SHAPE For Ministry CLASS 301 Discovering My SHAPE For Ministry CLASS 301 WELCOME TO DISCOVERING MY SHAPE (CLASS 301) THE PURPOSE FOR THIS CLASS: "(God) has given... pastors and teachers to prepare God's people for works of ministry,

More information

Journey with Jesus The Emmaus Road

Journey with Jesus The Emmaus Road Journey with Jesus The Emmaus Road A Sermon by Pastor Robyn Ramer Hogue Luke 24:13-35 April 15, 2018 Today s sermon is for people who sometime wonder, Is Jesus really real? It s for you if you ve ever

More information

Journal of Professional Exercise Physiology

Journal of Professional Exercise Physiology Do You Have a Plan For a Better Future? The ASEP Leaders Do! Journal of Professional Exercise Physiology ISSN 1550-963X Vol 9 No 1 January 2011 An Exercise Physiologist s Vision Tommy Boone, PhD, MPH,

More information

Facing Our Fear of the Future Psalm 23:6 Douglas Scalise, Brewster Baptist Church This past Christmas Jill s parents gave me a couple of

Facing Our Fear of the Future Psalm 23:6 Douglas Scalise, Brewster Baptist Church This past Christmas Jill s parents gave me a couple of 5.17.09 Facing Our Fear of the Future Psalm 23:6 Douglas Scalise, Brewster Baptist Church This past Christmas Jill s parents gave me a couple of books about excellence. One of them, Mind Gym, has a chapter,

More information

Dave Bergen, Executive Secretary, Christian Formation, Mennonite Church Canada Pastoral Trends Survey

Dave Bergen, Executive Secretary, Christian Formation, Mennonite Church Canada Pastoral Trends Survey 600 Shaftesbury Blvd Winnipeg MB R3P 0M4 Toll Free 1-866-888-6785 T: 204-888-6781 F: 204-831-5675 E: office@mennonitechurch.ca W: www.mennonitechurch.ca Thriving pastors Healthy churches Introduction Scratch

More information

Confessions Of A Surgeon: The Good, The Bad, And The Complicated...Life Behind The O.R. Doors PDF

Confessions Of A Surgeon: The Good, The Bad, And The Complicated...Life Behind The O.R. Doors PDF Confessions Of A Surgeon: The Good, The Bad, And The Complicated...Life Behind The O.R. Doors PDF As an active surgeon and former department chairman, Dr. Paul A. Ruggieri has seen the good, the bad, and

More information

MBSR Mindfulness Based Stress Reduction Program University of Massachusetts Medical Center School of Medicine, Center for Mindfulness

MBSR Mindfulness Based Stress Reduction Program University of Massachusetts Medical Center School of Medicine, Center for Mindfulness Used with permission of author Jon Kabat-Zinn, Ph.D. MBSR Mindfulness Based Stress Reduction Program University of Massachusetts Medical Center School of Medicine, Center for Mindfulness The Foundations

More information

Interview with Curt Tribble, Elite Surgeon

Interview with Curt Tribble, Elite Surgeon Journal of Excellence Issue No. 5 Tribble 117 Interview with Curt Tribble, Elite Surgeon Curt Tribble, Chief Surgeon and Head of the Department of Surgery, University of Virginia Medical Center and Terry

More information

When You Should Get Immediate Dental Treatment?

When You Should Get Immediate Dental Treatment? When You Should Get Immediate Dental Treatment? Most of the time, it can be tough to discern whether you want the assistance of an urgent Root Canal Dentist Near Me or should just need wait to see a routine

More information

PROXY AND DIRECTIVE WITH RESPECT TO HEALTH CARE DECISIONS AND POST-MORTEM DECISIONS

PROXY AND DIRECTIVE WITH RESPECT TO HEALTH CARE DECISIONS AND POST-MORTEM DECISIONS Developed and published by: Agudath Israel of America 42 Broadway, 14 th Floor New York, NY 10004 212-797-9000 The Halachic Living Will PROXY AND DIRECTIVE WITH RESPECT TO HEALTH CARE DECISIONS AND POST-MORTEM

More information

Why Good Science Is Not Value-Free

Why Good Science Is Not Value-Free Why Good Science Is Not Value-Free Karim Bschir, Dep. of Humanities, Social and Political Sciences, ETH Zurich FPF 2017 Workshop, Zurich Scientific Challenges in the Risk Assessment of Food Contact Materials

More information

The Ethical Canary: Science, Society, and the Human Spirit (2000, ISBN )

The Ethical Canary: Science, Society, and the Human Spirit (2000, ISBN ) THIS PAGE CONTAINS SOME RECENT ARTICLES BY PROMINENT AUSTRALIAN-BORN ETHICIST AND LAWYER MARGARET SOMERVILLE, PRECEDED BY A SHORT BIOGRAPHY Biographical Note (edited from Wikipedia) Margaret Anne Ganley

More information

PFP / 1 INTERVIEW SUMMARY DR. M. J. PHILLIPS. (Prepared: December 11, 2007)

PFP / 1 INTERVIEW SUMMARY DR. M. J. PHILLIPS. (Prepared: December 11, 2007) PFP303615 / 1 INQUIRY INTO PEDIATRIC FORENSIC PATHOLOGY IN ONTARIO The Honourable Stephen Goudge, Commissioner 180 Dundas Street West, 22 nd Floor Toronto, Ontario M5G 1Z8 COMMISSION D'ENQUÊTE SUR LA MÉDECINE

More information

You and I first met in 1980 when you were Chief of Pediatric

You and I first met in 1980 when you were Chief of Pediatric The following letters were exchanged between Gregg L. Cunningham of the Center for Bio-Ethical Reform and C. Everett Koop, former surgeon general of the United States, in the days following President Clinton's

More information

( ) ANN:? OUT ANN: ,

( ) ANN:? OUT ANN: , 2010 7 3 ( ) 2010 7 3 ( ) IN ANN:? 2010 7 3. 2010 7 3 3.. 1 17... OUT ANN: 3. 1 13, 14 17... - 1 - 1.,. M: Hey, Jenny, do you know our school is holding a mascot design contest for the No Bully Campaign?

More information

The surgeon looked up without expression. Is he ready? Ready is a relative term, said the med-eng. We re ready. He s restless.

The surgeon looked up without expression. Is he ready? Ready is a relative term, said the med-eng. We re ready. He s restless. Segregationist by Isaac Asimov Found in Isaac Asimov: The Complete Stories, Vol. 1, New York: Broadway Books, 1990. 605 609. Originally published in 1967. The surgeon looked up without expression. Is he

More information

Exploring Spirituality and Religious Beliefs

Exploring Spirituality and Religious Beliefs Exploring Spirituality and Religious Beliefs Introduction Barbara Lewis, MBA Managing Editor DocCom Stuart Sprague, PhD Clinical Associate Professor of Family Medicine at the Medical University of South

More information

Volume 12 Issue Travels to the Psych Ward: A Story of Comfort and Grief. Gina Nicoll

Volume 12 Issue Travels to the Psych Ward: A Story of Comfort and Grief. Gina Nicoll Travels to the Psych Ward: A Story of Comfort and Grief Gina Nicoll When my doctor first said she was sending me to the hospital, I tried to talk her out of it. Running my thumb over and over the spot

More information

[ B E L I E V E R S B I B L E S T U D Y ] THE GOSPEL OF JOHN Chapter 21

[ B E L I E V E R S B I B L E S T U D Y ] THE GOSPEL OF JOHN Chapter 21 [ B E L I E V E R S B I B L E S T U D Y ] THE GOSPEL OF JOHN Chapter 21 INTRODUCTION... The final chapter of the Gospel according to John opens with seven of the eleven disciples going fishing. While engaged

More information

Lessons From Timothy And Titus

Lessons From Timothy And Titus Lessons From Timothy And Titus Lesson 1 - Introduction and Background Texts: Acts 16:1-4; 17:14,15; 18:5; II Tim 1:5; 3:14-17; I Tim 1:3,4 Discussion Questions 1. What was the religious situation in Timothy's

More information

Lessons From Timothy And Titus. page1

Lessons From Timothy And Titus. page1 Lessons From Timothy And Titus page1 Lesson 1 - Introduction and Background Texts: Acts 16:1-4; 17:14,15; 18:5; II Tim 1:5; 3:14-17; I Tim 1:3,4 1. What was the religious situation in Timothy's family

More information

MONTH 5, VOLUME 4 THE HOPE OF CHRIST IN EVERY STUDENT. Hope. Weekly Guide School Year

MONTH 5, VOLUME 4 THE HOPE OF CHRIST IN EVERY STUDENT. Hope. Weekly Guide School Year MONTH 5, VOLUME 4 Hope THE HOPE OF CHRIST IN EVERY STUDENT Weekly Guide ATIENCE 2018-2019 School Year First Priority is a campus evangelism strategy implemented by the local church. MISSION: To unite the

More information

Phil 108, July 15, 2010

Phil 108, July 15, 2010 Phil 108, July 15, 2010 Foot on intending vs. foreseeing and doing vs. allowing: Two kinds of effects an action can have: What the agent merely foresees will happen because of his action. What the agent

More information

Virtual Mentor American Medical Association Journal of Ethics May 2012, Volume 14, Number 5:

Virtual Mentor American Medical Association Journal of Ethics May 2012, Volume 14, Number 5: Virtual Mentor American Medical Association Journal of Ethics May 2012, Volume 14, Number 5: 378-382. ETHICS CASE A University Physician s Duty to Nonpatient Students Commentary by Cynthia Geppert, MD,

More information

A Neurosurgeon s Personal Perspective Freedom-Privilege-Obligation Honor the Tradition-Serve the Sick-Advance the Field!

A Neurosurgeon s Personal Perspective Freedom-Privilege-Obligation Honor the Tradition-Serve the Sick-Advance the Field! A Neurosurgeon s Personal Perspective Freedom-Privilege-Obligation Honor the Tradition-Serve the Sick-Advance the Field! Introduction This morning I will tell you about my personal perspective as a neurosurgeon

More information

Near-Death Experiences and EEG Surges at End of Life

Near-Death Experiences and EEG Surges at End of Life LETTER TO THE EDITOR Near-Death Experiences and EEG Surges at End of Life To the Editor: Lakhmir Chawla and colleagues (2009) reported that patients who were at end of life and had life support withdrawn

More information

Conway Road St. Louis, MO

Conway Road St. Louis, MO D R. R I C H A R D W I N T E R C U R R I C U L U M V I TA E www.covenantseminary.edu 12330 Conway Road St. Louis, MO 63141 314.434.4044 1.800.264.8064 Dr. Richard Winter Professor Emeritus of Counseling

More information

The Halachic Medical Directive

The Halachic Medical Directive The Halachic Medical Directive PROXY AND DIRECTIVE WITH RESPECT TO HEALTH CARE AND POST-MORTEM DECISIONS FOR USE IN THE STATE OF DELAWARE The Halachic Medical Directive is designed to help ensure that

More information

Copyrighted material Prayers for Hope and Healing.indd 1 4/19/17 4:12 PM

Copyrighted material Prayers for Hope and Healing.indd 1 4/19/17 4:12 PM Unless otherwise indicated, all Scripture quotations are taken from the Holy Bible, New International Version, NIV. Copyright 1973, 1978, 1984, 2011 by Biblica, Inc. Used by permission. All rights reserved

More information

Suggested Intercessions for the Prayer of the Faithful

Suggested Intercessions for the Prayer of the Faithful Suggested Intercessions for the Prayer of the Faithful Please choose some of the following to be included among the intercessions in your parish Liturgy during National Natural Family Planning Awareness

More information

Sid: But you think that's something. Tell me about the person that had a transplanted eye.

Sid: But you think that's something. Tell me about the person that had a transplanted eye. 1 Sid: When my next guest prays people get healed. But this is literally, I mean off the charts outrageous. When a Bible was placed on an X-ray revealing Crohn's disease, the X-ray itself supernaturally

More information

Working with Core Beliefs of Never Good Enough

Working with Core Beliefs of Never Good Enough Working with Core Beliefs of Never Good Enough Laurel Parnell, PhD - Transcript - pg. 1 Working with Core Beliefs of Never Good Enough How EMDR Can Reprocess the Felt Sense of Never Good Enough with Ruth

More information

Being Single: Living for Christ in a world full of couples Jan. 10, 2016 Brian R. Wipf

Being Single: Living for Christ in a world full of couples Jan. 10, 2016 Brian R. Wipf 1 Being Single: Living for Christ in a world full of couples Jan. 10, 2016 Brian R. Wipf Today s message is entitled, Being Single: Living for Christ in a world full of couples. My title highlights some

More information

The little blue breathing book for BIG stress relief and relaxation

The little blue breathing book for BIG stress relief and relaxation DT The little blue breathing book for BIG stress relief and relaxation It s not always easy to feel balanced and fulfilled. Stress is often a factor. Science has solutions for you: 2 EASY STEPS based on

More information

INTRODUCTION TO QIGONG

INTRODUCTION TO QIGONG INTRODUCTION TO QIGONG A PATH TO WELLNESS THOMAS CALABRIS Copyright 2011-2013 by Inner Vitality Systems, LLC Check out our home study courses at: www.innervitalityqigong.com/home-study.html Introduction

More information

Adapting Mindfulness for Conservative Christian Clients

Adapting Mindfulness for Conservative Christian Clients Adapting Mindfulness for Conservative Christian Clients Fernando Garzon, Psy.D. AACC Webinar, Tuesday, May 31, 2016 fgarzon@liberty.edu http://works.bepress.com/fernando_garzon/ fgarzon@liberty.edu Liberty

More information

Fiqh in Medical Imaging A Conceptual Approach Work in Progress

Fiqh in Medical Imaging A Conceptual Approach Work in Progress Fiqh in Medical Imaging A Conceptual Approach Work in Progress Zainul Ibrahim bin Zainuddin Assistant Professor Department of Diagnostic Imaging and Radiotherapy Kulliyyah of Allied Health Sciences International

More information

ST. JEROME SCIENCE ACADEMY

ST. JEROME SCIENCE ACADEMY ST. JEROME SCIENCE ACADEMY 3310-107 Avenue, Edmonton, AB T: 780 479-5847 F: 780 479.7727 October 1, 2018 We have have had a very busy start of the school year at St. Jerome. Thank you to those of you who

More information

- 6 - Brown interviewed Kimball in the police station that evening and Kimball was cooperative and volunteered the following information:

- 6 - Brown interviewed Kimball in the police station that evening and Kimball was cooperative and volunteered the following information: - 6 - CONSTABLE M. BROWN CROWN WITNESS#1 Police Constable M. Brown (Brown) is 35 years old. Brown spent 7 years on traffic duty and for the last seven years has been on the homicide squad. Most of Brown's

More information

UnofficialCopyOfficeofChrisDanielDistrictClerk

UnofficialCopyOfficeofChrisDanielDistrictClerk NO. 1543812; 1543813 Filed18March06A9:00 ChrisDaniel-DistrictClerk HarrisCounty EA001_17192 By:LGODLEY STATE OF TEXAS IN THE 263 rd DISTRICT COURT v. Leon Jacob HARRIS COUNTY, TEXAS NOTICE OF INTENTION

More information

The Precautionary Principle and the ethical foundations of the radiation protection system

The Precautionary Principle and the ethical foundations of the radiation protection system The Precautionary Principle and the ethical foundations of the radiation protection system Friedo Zölzer University of South Bohemia, Czech Republic The moral philosophy underlying the recommendations

More information

The Word of the Lord. Thanks be to God. Let s Pray.

The Word of the Lord. Thanks be to God. Let s Pray. 1 Encourage Others Please turn with me to 1 Thessalonians 4:13-5:11. 1 Thessalonians 4:13-5:11 New International Version (NIV) Believers Who Have Died 13 Brothers and sisters, we do not want you to be

More information

Malawi Amoto Flames of Fire

Malawi Amoto Flames of Fire Malawi Amoto Flames of Fire Sports Friends Malawi Director, Luke Voight, shares about how the ministry is breaking new ground Also (page 2), Luke tells the story of Jane, a netball coach with the Evangelical

More information

INTERPERSONAL EFFECTIVENESS

INTERPERSONAL EFFECTIVENESS Page1 Lesson 4-2 FACTORS THAT REDUCE INTERPERSONAL EFFECTIVENESS Page2 Ask Yourself: FACTORS THAT REDUCE INTERPERSONAL EFFECTIVENESS * What is it that gets in the way of me getting what I want and need?

More information

Relocating for the Gospel

Relocating for the Gospel Report 1.2 on Survey of Aspiring Missionaries Relocating for the Gospel March 23, 2017 John McVay Don Parrott BackgrOUnd The 2015 Launch Survey of 466 missionaries (online at launchsurvey.wordpress.com)

More information

An Example of Lifelong Learning: Monte S. Nyman

An Example of Lifelong Learning: Monte S. Nyman Religious Educator: Perspectives on the Restored Gospel Volume 12 Number 2 Article 14 7-1-2011 An Example of Lifelong Learning: Monte S. Nyman Monte S, Nyman Follow this and additional works at: https://scholarsarchive.byu.edu/re

More information

ESALEN INSTITUTE CONTINUING EDUCATION MFT/LCSW/LPCC/LEP (CAMFT), RN (CA BRN) & MASSAGE (NCBTMB)

ESALEN INSTITUTE CONTINUING EDUCATION MFT/LCSW/LPCC/LEP (CAMFT), RN (CA BRN) & MASSAGE (NCBTMB) ESALEN INSTITUTE CONTINUING EDUCATION MFT/LCSW/LPCC/LEP (CAMFT), RN (CA BRN) & MASSAGE (NCBTMB) Leader Name/s: Davida Taurek & Peter Selwyn Workshop Title: 5Rhythms : Grief, Loss, and the Body in Motion

More information

MEDICAL DURABLE POWER OF ATTORNEY FOR HEALTH CARE AND DECLARATION FOR USE IN COLORADO

MEDICAL DURABLE POWER OF ATTORNEY FOR HEALTH CARE AND DECLARATION FOR USE IN COLORADO The Halachic Living Will MEDICAL DURABLE POWER OF ATTORNEY FOR HEALTH CARE AND DECLARATION FOR USE IN COLORADO The Halachic Living Will is designed to help ensure that all medical and post-death decisions

More information

As noted, a deductive argument is intended to provide logically conclusive support for its conclusion. We have certainty with deductive arguments in

As noted, a deductive argument is intended to provide logically conclusive support for its conclusion. We have certainty with deductive arguments in As noted, a deductive argument is intended to provide logically conclusive support for its conclusion. We have certainty with deductive arguments in that if the premises of the argument are true, then

More information

Work. Prayers. Healing. If you perceive you re being prayed for and you are being prayed for, you ll likely feel better.

Work. Prayers. Healing. If you perceive you re being prayed for and you are being prayed for, you ll likely feel better. Healing Prayers That Work If you perceive you re being prayed for and you are being prayed for, you ll likely feel better. By Allan J. Hamilton, M.D. / Photography by Dana Edmunds n March 2006, the largest

More information

Mark Scheme (Results) Summer GCSE Religious Studies (5RS15) Buddhism

Mark Scheme (Results) Summer GCSE Religious Studies (5RS15) Buddhism Scheme (Results) Summer 2012 GCSE Religious Studies (5RS15) Buddhism Edexcel and BTEC Qualifications Edexcel and BTEC qualifications come from Pearson, the world s leading learning company. We provide

More information

An Example at Any Age

An Example at Any Age Promises, Promises Ruth 1:1-18 An Example at Any Age I Timothy 4:7b-12 By Rev. Jeffrey ByV. O Grady June 26, 2016 Rev. Jeffrey V. O Grady Pastor January 14, 2007 San Marino Community Church 1750 Virginia

More information

It was Friday morning,

It was Friday morning, Journey of Faith A Healing Miracle of the Holy Rosary This touching story gives powerful testimony to the grace and miracles we can receive through the trusting recitation of the Most Holy Rosary. Here,

More information

Witness Statement of -

Witness Statement of - SUBM.0035.001.0001 Witness Statement of - I wish to write to the Royal Commission from the perspective of a child growing up in a household of domestic violence and abuse. I want to write concerning the

More information

Department of Surgery. Quarterly Progress Report on Strategic Goals

Department of Surgery. Quarterly Progress Report on Strategic Goals Department of Surgery Quarterly Progress Report on Strategic Goals Strategic Priorities The Department of Surgery has three priorities that were set at a visioning session almost one year ago. These include:

More information

Strong Medicine Interview with Kimberly Mills, 25 September JOAN ILACQUA: [00:00] This is Joan Ilacqua, and today is

Strong Medicine Interview with Kimberly Mills, 25 September JOAN ILACQUA: [00:00] This is Joan Ilacqua, and today is Strong Medicine Interview with Kimberly Mills, 25 September 2014 JOAN ILACQUA: [00:00] This is Joan Ilacqua, and today is September 25th, 2014. I m here with Kimberly Mills at Children s Hospital, Boston,

More information

While everyone was asleep his enemy came and sowed weeds all through the wheat, and then went off (Mt 13:25). 16 th Sunday in Ordinary Time Cycle A

While everyone was asleep his enemy came and sowed weeds all through the wheat, and then went off (Mt 13:25). 16 th Sunday in Ordinary Time Cycle A While everyone was asleep his enemy came and sowed weeds all through the wheat, and then went off (Mt 13:25). 16 th Sunday in Ordinary Time Cycle A July 17 th, 2011 First Reading: Wisdom 12:13, 16-19 13

More information

Office Emergencies Are you really ready?

Office Emergencies Are you really ready? Office Emergencies Are you really ready? H. Mitchell Shulman MDCM FRCPC CSPQ Attending Physician, Emergency Dept, MUHC Assistant Professor, Dept of Surgery Copyright 2017 by Sea Courses Inc. All rights

More information

Faculty Name: Aasim Padela, MD, MSc Presentation Title: Constructing an "Islamic" Bioethics? Critical Concepts from Theology and Law

Faculty Name: Aasim Padela, MD, MSc Presentation Title: Constructing an Islamic Bioethics? Critical Concepts from Theology and Law Faculty Evaluation Faculty Name: Aasim Padela, MD, MSc Presentation Title: The Actors and Material of Islamic Bioethics Describe the different disciplinary experts and their goals with respect to producing

More information

Why is love the greatest?

Why is love the greatest? Title: Love is the Greatest Forever! Text: 1 Corinthians 13.13 Theme: Love is forever Series: 1 Corinthians #76 Prop Stmnt. We love now as taste of what life with Christ is going to be. Read Text: Normally,

More information

LG Weekly. Throughout scripture, God continually says, Let s go. From Abraham, Moses and Gideon to Mary,

LG Weekly. Throughout scripture, God continually says, Let s go. From Abraham, Moses and Gideon to Mary, Let s Go Let s Go Slow Chad Bruegman 5.14.17 LG Weekly START To get things started, go around the circle and answer these two questions: If you could only listen to one artist/band for the rest of your

More information

ADJUNCT FACULTY EMPLOYMENT APPLICATION

ADJUNCT FACULTY EMPLOYMENT APPLICATION - ADJUNCT FACULTY EMPLOYMENT APPLICATION John Brown University is an independent, interdenominational, evangelical Christian institution founded in 1919. Its basic task is to provide Christ-centered higher

More information

ETHICS IN PUBLIC SPEAKING by Remy Ashe

ETHICS IN PUBLIC SPEAKING by Remy Ashe ETHICS IN PUBLIC SPEAKING by Remy Ashe What is Ethics? Ethics is the moral dimension of human conduct. Ethics is derived from the Greek word ethos, meaning Character. Codes of ethical speech are built

More information

DAILY SCHEDULE CMEs: 25 as of July 20, 2017 Content and faculty subject to change

DAILY SCHEDULE CMEs: 25 as of July 20, 2017 Content and faculty subject to change 19th Annual AAOS Workers' Compensation and Musculoskeletal Injuries: Improving Outcomes with Back-to-Work, Legal and Administrative Strategies #3056 November 3-5, 2017; Las Vegas, NV, Course Director;

More information

Exams. ICAI Perspective, Performance. Expectations and. CA Shriniwas Y. Joshi

Exams. ICAI Perspective, Performance. Expectations and. CA Shriniwas Y. Joshi Exams ICAI Perspective, Expectations and Performance CA Shriniwas Y. Joshi 1 ICAI PERSPECTIVE To create world class professionals To be partners in Nation Building CA Shriniwas Y. Joshi 2 EXPECTATIONS

More information

The Halachic Medical Directive

The Halachic Medical Directive The Halachic Medical Directive PROXY AND DIRECTIVE WITH RESPECT TO HEALTH CARE AND POST-MORTEM DECISIONS FOR USE IN NEW YORK STATE The Halachic Medical Directive is designed to help ensure that all medical

More information

Please fill out this application completely and return to

Please fill out this application completely and return to Please fill out this application completely and return to CIMEvents@SOM.Umaryland.edu Bonnie Tarantino will schedule a phone interview with you within two weeks of receiving your application. Thank you,

More information

I MADE A COVENANT WITH MY EYES JOB 31:1

I MADE A COVENANT WITH MY EYES JOB 31:1 I MADE A COVENANT WITH MY EYES JOB 31:1 By Don Krider Job is one of my favorite books in the Bible. He's got these three miserable counselors who had some right words but the wrong spirit. They weren't

More information

HANDLE WITH CARE # 1 SPIRITUAL DISCIPLINE BIBLE INTAKE 2/17/2015 RIGHTLY DIVIDING THE WORD OF TRUTH. Hearing the Word.

HANDLE WITH CARE # 1 SPIRITUAL DISCIPLINE BIBLE INTAKE 2/17/2015 RIGHTLY DIVIDING THE WORD OF TRUTH. Hearing the Word. HANDLE WITH CARE RIGHTLY DIVIDING THE WORD OF TRUTH An Equipping Class based on How to Study Your Bible Precept Ministries International # 1 SPIRITUAL DISCIPLINE BIBLE INTAKE Hearing the Word Reading the

More information

They asked me what my lasting message to the world is, and of course you know I m not shy so here we go.

They asked me what my lasting message to the world is, and of course you know I m not shy so here we go. 1 Good evening. They asked me what my lasting message to the world is, and of course you know I m not shy so here we go. Of course, whether it will be lasting or not is not up to me to decide. It s not

More information

LESSON 43. PLUG IN TIME minutes as the kids begin to arrive

LESSON 43. PLUG IN TIME minutes as the kids begin to arrive LESSON 43 1 st and 2 nd Grade Principle: We are here to fulfill God s purpose, even if it means sacrifice. Bible Character(s): Esther Scripture Reference: Esther 2-7 PERSONAL PREPARATION: Before this weekend,

More information

Interview with Dr. Robert Ostfeld By OUR HEN HOUSE Published March 22, 2014

Interview with Dr. Robert Ostfeld By OUR HEN HOUSE Published March 22, 2014 Interview with Dr. Robert Ostfeld By OUR HEN HOUSE Published March 22, 2014 Following is a transcript of an interview with DR. ROBERT OSTFELD conducted by JASMIN SINGER and MARIANN SULLIVAN of Our Hen

More information

Welcome to Progress in Community Health Partnerships s latest episode of our Beyond the Manuscript podcast. In

Welcome to Progress in Community Health Partnerships s latest episode of our Beyond the Manuscript podcast. In BEYOND THE MANUSCRIPT 401 Podcast Interview Transcript Erin Kobetz, Maghboeba Mosavel, & Dwala Ferrell Welcome to Progress in Community Health Partnerships s latest episode of our Beyond the Manuscript

More information

Patient Care: How to Minister to the Sick

Patient Care: How to Minister to the Sick Part 2 of 2: Practical Advice for Ministering to Patients with,, Release Date: January 2014 I want to share a little bit to you about how the hospital for me is a difficult place. My mother died of cancer

More information

PROFESSIONAL SUPERVISION. A process of Reflection on Ministry Experience

PROFESSIONAL SUPERVISION. A process of Reflection on Ministry Experience PROFESSIONAL SUPERVISION A process of Reflection on Ministry Experience The Uniting Church in Australia Ministerial Education Commission 2011 Published by the Uniting Church Assembly s Ministerial Education

More information

Synod Clergy Well-being Working Party

Synod Clergy Well-being Working Party Synod Clergy Well-being Working Party Care and Care for the Carers are intrinsically linked not least by the concepts of responsibility and accountability proposed by the setting up of a Covenant for Clergy

More information

Be a Change Agent: The Founder of Home Depot Turns to Integrative Health An Interview with Bernie Marcus 1. Stephen K. Klasko 2 *

Be a Change Agent: The Founder of Home Depot Turns to Integrative Health An Interview with Bernie Marcus 1. Stephen K. Klasko 2 * Be a Change Agent: The Founder of Home Depot Turns to Integrative Health An Interview with Bernie Marcus 1 Stephen K. Klasko 2 * S pend your time looking forward, Bernard Bernie Marcus tells us. The co-founder

More information

Spirituality and Bereavement in End of Life Care

Spirituality and Bereavement in End of Life Care Spirituality and Bereavement in End of Life Care Rev Meg Burton MA, BTh Head of Chaplaincy, RDaSH End of Life Care Lead, CHCC Rev Debbie Hodge MA, BSc Sec Health Care Chaplaincy FCG Chief Officer HCFBG

More information

I am a physician, a healer by

I am a physician, a healer by Introduction I am a physician, a healer by profession. Over the past two decades, I have written thousands of prescriptions to help support, sustain, and heal my patients cardiovascular systems. Treating

More information

SURPRISING INSIGHTS FROM THE UNCHURCHED AND PROVEN

SURPRISING INSIGHTS FROM THE UNCHURCHED AND PROVEN SURPRISING INSIGHTS FROM THE UNCHURCHED AND PROVEN WAYS TO REACH THEM by Thom Rainer. This is a summary by Terran Williams of the recommended book by Thom Rainer with the above name. The hope is that some

More information