TCI News
TCI Hospital hosts Medical Ethics Symposium on ‘Informed Consent’
#Providenciales, September 19, 2018 – Turks and Caicos – InterHealth Canada – Turks and Caicos Islands Hospital hosted a Medical Ethics 
Symposium for nearly 70 health care professionals at the Cheshire Hall Medical Centre on September 14th, 2018 under the theme “Informed Consent – Recommended Best Practices.”
Informed consent is based on the moral and legal premise of patient autonomy and their right to make decisions about a particular treatment or test with an understanding of the risks and benefits. The symposium was developed to exchange knowledge on the latest best practices, common challenges and pitfalls associated with soliciting informed consent from patients.
Claire Horner, a Clinical Ethicist, Lawyer and Assistant Professor at the Centre for Medical Ethics and Health Policy at Baylor College of Medicine gave a keynote presentation. Horner stressed that informed consent is a process and not simply a form. This process involves several critical elements including disclosure of information, effective documentation, a patient’s right to refuse treatment and exceptions to the informed consent rule in cases of emergency, incapacity, waiver or therapeutic privilege.
The presentation provided an overview of the ethics of informed consent, shared decision-making, cognitive biases, decision aids, the difficulties associated with hard cases and what health care professionals should avoid. Other speakers based at the medical facility included Dr. Henry Blythe, General Practitioner who provided a regional perspective in partnership with Dr. Dionne Ranglin-Robinson, Anesthesiologist, who evaluated several key findings from a unique study on informed consent. The event was chaired by TCI Hospital Chief of Medical Services, Dr. Denise Braithwaite-Tennant.
Advance healthcare directives, or a living will that pre-documents a patient’s wishes concerning medical treatments at the end of life or incapacitation is a growing practice in many jurisdictions. Persons are encouraged to make decisions ahead of time so their care is aligned with their preferences and/or nominate a relative or friend to be their alternate decision maker in cases where informed consent is required.
During the visit to the medical facility, Horner also conducted a special CME session and reviewed the hospital’s current policies and standards of practice related to informed consent. The expert’s recommendations will be used to further strengthen the existing framework. Other areas examined included practices related to Do Not Resuscitate (DNR) Orders and the withdrawal of Life-Sustaining Care. The symposium is held every two years, and is extended to health care practitioners from across the country to promote standardized practices across community medical facilities to benefit the patient’s continuum of care.
Commenting on the symposium, Chairman of the Medical Ethics Committee at TCI Hospital, Dr. Henry Blythe said: “Informed consent represents one of the major tenets of medical ethics. This consent may be in the form of a consent document, verbal or implied. There are some cases that require written consent such as invasive procedures. It is important for our staff to be knowledgeable of the different scenarios where each of these cases apply. As part of our quality improvement, we want patients to become more involved in their care. It is okay to ask why, or disagree with a proposed treatment. It is important to require full disclosure. Medical care should no longer be approached in a paternalistic manner and patients have the right to question their care.”
TCIG knew from April that fuel factor could surge almost 80%; Minister says $500 cost-of-living payment was part of Government’s response
PROVIDENCIALES — The Turks and Caicos Government knew months before July’s shocking electricity bills that consumers faced a potentially massive increase in the fuel factor.
Minister of Information Technology and Energy E. Jay Saunders revealed Friday that Pelican Energy warned his Ministry in April that generation fuel costs were projected to rise from $3.09 per gallon in May to $4.79 in June and July.
That translated into a projected fuel factor jump from about 17.5 cents to 31 cents per kilowatt-hour — an increase of almost 80%.
Saunders said he personally advised Cabinet of the projected increase and presented options for cushioning the impact.
He characterised Government’s $500 cost-of-living payment as its “initial response” to rising fuel costs, before a separate fuel-factor subsidy was approved.
Cabinet records show Government agreed on June 24 to provide funding to mitigate the fuel-factor impact, with the relief programme approved July 8.
Eligible residential customers — those averaging less than $1,500 monthly over the previous three bills — are capped at 22 cents per kWh from July through October.
Pelican confirmed Friday that Government’s contribution was already applied to July bills, meaning the bills now triggering widespread public outrage would have been even higher without the subsidy.
Saunders did not disclose the programme’s total cost.
His admission that Government knew since April, however, raises another question amid the backlash: why were consumers not directly warned by Government about the scale of the approaching increase?
PROVIDENCIALES — New commercial Crown Land applications are facing a six-month pause as the Turks and Caicos Islands Government takes inventory of its holdings.
During Cabinet meetings held July 15 and 16, an immediate six-month moratorium was approved on the acceptance, processing
and approval of new applications for commercial Crown Land grants, leases and allocations.
The pause will remain in place pending completion of the Crown Land Inventory Review. Cabinet’s summary did not state what prompted the review or indicate whether availability of commercial Crown Land is a concern.
The two-day meeting also advanced major consumer legislation. Cabinet approved the National Fair Competition Policy 2026 and drafting instructions for a Fair Competition Ordinance, moving TCI toward stronger consumer protection and fair competition rules.
In Grand Turk, Cabinet approved rezoning land in the North West Suburbs from low-density to medium-density residential use to facilitate a new apartment development.
Cabinet also advanced fisheries reforms, water legislation allowing private and public-private investment, minerals legislation and appointments across tourism, health and finance.
Progress toward establishing a TCI Credit Union was also noted.
PROVIDENCIALES — Major development projects outside Providenciales received Cabinet attention on July 8, with Government approving agreements connected to the redevelopment of Dellis Cay and a resort development in North Caicos.
Cabinet approved a Development Agreement between the Turks and Caicos Islands Government, Desarrollos Hotelco DC Ltd. and
Desarrollos Hotelco Astoria Ltd. for the redevelopment of Dellis Cay.
The long-discussed private island development sits between Providenciales and North Caicos and its return to Cabinet signals another step toward redevelopment.
Cabinet also approved amendments to an agreement involving SPR LND Ltd. (Royal Reef) and TCIG Development Agreement for a resort/hotel development in North Caicos.
Other decisions included approval of the First Supplementary Appropriation Bill 2026 for onward transmission and the appointment of Cindy Ewing as Chair of the Invest TCI Board, effective August 1 for three years.
Cabinet also noted consultation outcomes concerning changes to business licensing, approved professional membership expenses for qualifying Telecommunications Commission staff and approved advice relating to the Interim Clinical and Estates Services PPP.
The July 8 meeting was chaired by Acting Governor Anya Williams.
Photo Credit: Royal Reef (Keith)
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