A living ethics lab in a rehabilitation hospital: Concept and initial development

Arthur Filleul, n/a – PhD student, Bioethics, Université de Montréal; Matthew Hunt – McGill; Julien Dery – Occupational Therapy – Université du Québec à Trois-Rivières; Camille Desforges – Scientific coordinator, Laboratoire d'Ethique Vivante en Réadaptation; Eric Racine – nité de recherche en éthique pragmatique de la santé – Institut de recherches cliniques de Montréal; Anne Hudon – Physiotherapy – Université de Montréal; Scientific Committee Levier – Laboratoire d'Ethique Vivante en Réadaptation

Abstract: Rehabilitation hospitals face a range of ethical challenges, such as the equitable allocation of resources and managing the opioid crisis in chronic pain treatment. These issues lead to value conflicts, patient frustration, and clinician moral distress, contributing to staff retention difficulties. Additionally, administrators and clinicians often lack the training and resources to make informed ethical decisions.

LEViER is an innovative living ethics lab aimed at identifying ethical issues in rehabilitation and creating practical solutions. This project, based at the Institut de réadaptation Gingras-Lindsay-de-Montréal (IRGLM), focuses on addressing the ethical dilemmas faced by rehabilitation administrators. The project is grounded in "living ethics," which prioritizes dialogue and collaboration, fostering open discussions on ethical issues and promoting collective problem-solving.

This presentation will introduce the LEViER program and the results from phase 1, which involved semi-structured interviews and focus groups with rehabilitation administrators to identify key ethical challenges. These findings inform phase 2, which involves participatory workshops where administrators, clinicians, patients, and families co-create practical solutions to real-world ethical issues, guiding policy development. Phase 3 will pilot test these solutions at IRGLM, using real-time feedback to refine and ensure their effectiveness and sustainability.

LEViER innovates by incorporating the perspectives of all stakeholders in rehabilitation care to develop ethically sound, contextually relevant, and innovative solutions, building on similar efforts to create a dynamic framework for enhancing staff well-being and patient care quality through collaboration.

Keywords: Living ethics, Rehabilitation, organizational ethics