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.