Articles Tagged With:
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Ethical Considerations for Patient, Family, and Staff if LVAD Is Deactivated
An estimated 2,500 heart failure patients have left ventricular assist devices (LVADs) implanted each year. In some cases, the burdens of the LVAD outweigh the benefits, so a decision is made to deactivate the device in the hospital setting.
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Goals of Care Discussion Took Place — But Was it Documented?
When clinicians discuss patient goals and preferences, the discussion needs to be added to the medical record for other healthcare providers to access the information when necessary. Yet the documentation often is missing or incomplete.
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Long-Term Care Providers Frequently Face Ethical Dilemmas
Ethical conflicts are common in long-term care facilities, but access to ethics resources often is lacking in these settings. “Access to ethics consultation can reassure everyone involved that the medical director, nurse, or administrator isn’t missing something,” says David N. Hoffman, JD, assistant professor of bioethics at Columbia University.
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Some Surrogate Decision-Makers Are Unprepared — or Unaware — of Role
One of the most important goals of advance care planning is to prepare surrogate decision-makers for their role, according to Lingsheng Li, MD, MHS, a research fellow in geriatrics and palliative care at UCSF. Yet Li and colleagues often heard the opposite from surrogates. Many admitted being entirely unprepared for the decision-making process.
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Intervention Reduces Distress of Surrogates
Being a surrogate decisionmaker in the intensive care unit (ICU) can have long-term psychological consequences, including post-traumatic stress.
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Timing of Ethics Consults Varies by Diagnosis, Language, and Ethnicity
Farshid Dayyani, MD, PhD, joined the ethics committee at University of California Irvine (UCI) Medical Center in 2020. Then, the pandemic hit. Dayyani and colleagues wanted to know if patient characteristics (language, diagnosis, and race/ethnicity) affected the timing of ethics consult requests or the ethics team’s recommendations. There were limited data showing some racial and gender disparities in delays to obtaining ethics consults. The researchers saw the need for a more comprehensive analysis of ethics consults.
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Are Ethics Committees Effective? Some Are Being Replaced with Alternative Model
The vast majority of hospitals have ethics committees. Yet these committees vary in terms of their effectiveness, leading some ethicists to conclude it is time for a new approach.
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Envenomations Update
This article will give an overview of medically important non-marine envenomations in the United States, including their clinical manifestations, treatment, and disposition.
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Identifying and Managing Rocky Mountain Spotted Fever
Rocky Mountain spotted fever is an infectious disease that may be rapidly fatal if not rapidly recognized based on clinical findings and early institution of appropriate antibiotic therapy. The epidemiologic shift of this disease makes it important for all healthcare providers to be familiar with the current status, clinical presentation, and therapy for Rocky Mountain spotted fever.
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Navigating Hypoglycemia in Diabetes Care: Clinical Management Strategies and Glucagon Treatment Options
Hypoglycemia, defined as a blood glucose level less than 70 mg/dL, can be life-threatening, particularly with insulin therapy, and imposes a significant risk factor leading to severe morbidity and increased medical costs. As a preventable and potentially acute complication of diabetes management, providing proper patient education, identifying key risk factors, and tailoring treatment approaches are crucial for prevention.