Overview

The COVID-19 pandemic continues to provide salient examples of the built environment’s impact on disease morbidity and mortality. While design changes are being proposed to address various high-risk design elements like congregate living quarters, it is uncertain whether or not these changes will be ethically informed. Advances in architectural design and a growing understanding of its powerful effects on health outcomes suggest that healthcare environments should be regarded as medical interventions. This panel will explore the ethical challenges related to architectural design modifications aimed to mitigate disease spread and improve quality of life. Examples will be drawn from proposed changes to long term care facilities and hospitals, as both are confined environments in which vulnerable populations live, in which healthcare is provided, and in which organizations have a duty of care to persons inhabiting those spaces.

Ethical challenges discussed will include: isolation for disease control versus the necessity of human socialization and autonomy, risks posed to staff versus the necessity of care provision, and the relationship between institutional policy and the built environment in disease control and well-being. The panel will inspire and empower attendees from various backgrounds to host compelling discussions with healthcare leaders and clinicians on how to utilize the built environment to improve out comes in their organizations.

Learning Objectives:

• Appreciate the increasing impact the healthcare built environment is having on health out comes.
• Understand how t he built environment can help resolve t he conflicting obligations of isolation for disease mitigation and the need for socialization and autonomy.
• Reflect on t he built environment as a dimension of duty of care.

IKM Presents: Health Equity by Design
John Keelan, Dr. Diana Anderson, Juliet Rogers, Dr. Bon Ku

This panel explores the power of design to improve disparities in health. Panelists will upend current health care models, formulating systems that improve outcomes for all patients.

Session Overview

Over the past fifty or so years, our understanding of the role the environment plays in shaping us and our interactions has expanded immensely. Studies of social determinants of health have illuminated profound effects social factors and environment can have on medical outcomes and well-being. Studies of behavior have demonstrated the powerful effect environmental factors can have on decision-making. It is somewhat surprising, therefore, so little attention has been paid to the bioethics of the built environment in healthcare. We all know intuitively that the spaces we spend time in affect us, and while some intrepid healthcare architects have been exploring the power of environmental factors on behavior for decades, virtually none of this terrain has been contemplated in bioethics.

The physical environment in healthcare architecture has been associated with numerous quality and outcomes issues. As we will show, design choices can result in substantive ethical issues for not just the marginalized and vulnerable, but all of us, leading some to call for a shared decision-making in healthcare architecture that mirrors the movement in clinical medicine. In this panel discussion, we will begin by outlining a series of ethical issues in healthcare design, including the use of illusion, living laboratories, and the prevention or imposition of harm through design. We then examine the state of research practices in healthcare architecture: what has been accomplished, what hasn’t, and the challenges that lie ahead. We conclude by inviting the audience to discuss the role of bioethics in healthcare architecture.

Learning Objectives – At the end of this session, attendees will be able to:

• Discuss the role the built environment plays in wellbeing and medical outcomes and provide several examples.
• Be familiar with some of the most pressing ethical issues arising out of design decisions in healthcare architecture and be able to describe both evidence-based considerations and theoretical concerns.
• Articulate the state of research in healthcare architecture, discuss the challenges of implementing modern research practices in ongoing and future work, and the benefits of solving the issues involved.