Posted by Carrie Fenn on Sep 23, 2020

Our speaker today is Cindy Bruzzese. Cindy is the executive director at the Vermont Ethics Network. She is a native Vermonter and has worked at the VEN since 2008. She works as a medical ethicist at UVM in addition to a myriad of other roles. 

 
9.23.2020
CSH Rotary via Zoom
Robert Sanders, Carrie Fenn, Fritz Horton, Linda Barker, Charlie Kofman, Chris Davis, Susan Grimes, Linda Gilbert, Nancy Danforth, France LeBlanc, Rosalyn Graham, Adam Bartsch, Denis Barton, John Pane, John Hammer, Ric Flood, Jonathan Lowell, Bill Deming, Keith Walsh, Jim Donovan, Dan York, Joan Lenes, Jessica Brumstead, Diana Vichon, Tina Flood
 
Chris Davis called the meeting the order at 7:30 am.
France was recognized for her incredible work at the last Racevermont race. 
Chris noted that the last race will be on November 9, and he will need lots of volunteers. The race will take place at the Shelburne Field House. 
 
Susan Grimes shared these opening words from  Ruth Bader Ginsburg
“If you want to be a true professional, you will do something outside yourself, something to repair tears in your community, something to make life a little better for people less fortunate than you.”
 
The budget through December has been presented for approval. Not included in the budget is a proposed $500 for public relations and monies for the bike rack. The budget as outlined allocates $7000 for Thanksgiving turkeys and hams. Bob was pleased to see the donations that have come in from Rotarian in lieu of breakfast fees. Bob made a motion to approve the budget through December, the motioned was seconded and the motion carried unanimously.
 
Chris has run into a little trouble with AARP to line up our charitable foundation, club name and bank account name to get the donation money, but we’re only $200 off from raising the funds. 
 
Charlotte and Hinesburg turkeys will be ordered through Lantman’s, and the Shelburne food shelf said they would fund the Christmas hams.
 
Winter coats! Chris had a dialogue with the school counselor at Hinesburg. She has been outreaching with the Williston principal and the other counselors to develop a form to get more detailed information regarding the needs in each school. They are doing the homework on the school’s end, and Williston Rotary will be stepping in to work with the Williston schools. We are looking for the Czar or Czarina to take on chairmanship of this project, with support from the board. France would like to help out. 
 
Carrie, Susan and Chris will work up some text and run it by Richard and France, then send to PR to push out the message.
 
The school lunch program is going well and could still use volunteers Mondays Wednesdays and Thursdays at Charlotte, Shelburne and Hinesburg schools. Please email Carrie for more information.
 
Fritz is part of the Shelburne Conservation Commission, and they are looking for matching funds to help revitalize the Shelburne Town clock. Lee Crohn will submit the application to the state for the matching grant on October 5, and all the funds have to be in hand at that time. 
 
Our speaker today is Cindy Bruzzese. Cindy is the executive director at the Vermont Ethics Network. She is a native Vermonter and has worked at the VEN since 2008. She works as a medical ethicist at UVM in addition to a myriad of other roles. 
 
Vermont Ethics Network is a nonprofit organization based in Montpelier, doing work all over Vermont and some parts of New Hampshire. VEN is most known for their work on advanced care planning, which used to be known as “living wills.” VEN has moved into working with all health care facilities to help people navigate the thorny questions that come up at the bedside and taking on questions that happen frequently, to not only manage those ethics questions but to try to prevent them from happening all together.
Cindy is also the director of the State Commission on Palliative Care and Pain Management, which strives to provide good end of life care across the state. 
 
An ounce of prevention is worth a pound of cure- a lot of the work Cindy does is to prevent conflict. “How could we have prevented this from happening?” ACP is an ongoing process of discussing, understanding, planning and documenting an individual’s goals, values and wishes for future health care. How do we make sure that what we are doing aligns with what that person wants us to be doing? High value care is doing what people want, not what we can do.
The minute an individual turns 18, she should have a plan to designate who can make decisions for her if she is unable to make decisions for herself.  If there is no plan, in Vermont the law does not dictate, and this is where problems arise.
Name a Health Care Agent- who knows you best and can speak to your wishes?
Advance Directive with preferences- person centered approach to thinking about an individual’s priorities regarding her health care, thinking about the whole person and not a particular diagnosis. Documents should be updated as we move through our lives. Tools exist to document health decisions and 2 witnesses create a legal document.
 
Taking Steps Vermont: Who’s Your Person, What’s Your Plan?
  • Appointment of a health care agent form
  • Advance directive short form
  • Advance directive long form
  • DNR/COLST (clinician order for life sustaining treatment, like ventilators, intubation, feeding tubes etc) order
  • Vermont advance directive registry- free depository that safeguards the document.
What to do with document:
  • Make copies
  • Keep the original
  • Share with your lawyer and loved ones
Questions?
 
We have an ethical framework- what would that person want? What would most people choose? These questions often are superseded by life-saving and life sustaining efforts. What is in the person’s best interests? If family members can’t come together, the courts will intervene and assign guardianship.
Cindy likes the somewhat gray structure because they are able to work to find who knows the person best as opposed to simply the first person on the list. 
Advanced directives and health care agents are recognized across state lines. Patient self- determination is a law at the federal level so there is very good reciprocity. 
The most current document is the prevailing document. Sometimes people will do them with their attorneys, and then will do a new form. The new document supersedes and will be the one that is followed. 
Every state has some form of an advanced directive law. 
 
Respectfully submitted,
Carrie Fenn