Medical Ethics Advisor – December 1, 2022
December 1, 2022
View Issues
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Medical Crowdfunding Is Not Providing a Proper Safety Net for the Neediest Patients
While safety nets are supposed to catch everyone in need equally, crowdfunding can be more effective for some people than others. People in states with more uninsured populations, worse poverty, and higher rates of medical debt are more likely to try to raise funds, but are less likely to succeed.
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Staffing Shortages Are Hindering Clinical Trial Completion
Some sites are curtailing new enrollment across all studies, or at least for studies that are not as economically sustainable as others. Sites estimate the average added cost to recruit and train a new patient-facing staff member is approximately six months pay. Due to the limited availability of qualified research staff, sites are replacing research coordinators with individuals without clinical research experience.
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Ethical Concerns if Researchers Examine Opioid Use During Pregnancy
Researchers who are examining opioid use in pregnant patients face significant ethical complexities when designing study protocols. A group of ethicists examined these issues and concluded an embedded approach to address ethical implications of these studies is needed.
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Unused Donated Organs, Transplant Inequities Lead to Calls for Systemic Changes
There is longstanding inequity in access to transplantation, substantial nonuse of donated organs, and unexplained variability in performance across the transplant system, according to a recent report.
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Ethical Use of Restraint Hinges on Decision-Making Capacity
The situation becomes ethically complex if the patient’s capacity is unclear, ambiguous, or fluctuating. It is much harder to know if, when, and how to avoid inflicting harm while balancing the patient’s legal and ethical right to make their own decisions.
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Medical Incapacity Holds Require Ethical Oversight
Clinicians feel conflicted about their ethical obligations. On one hand, they know it is unsafe for a confused person to be allowed to walk out of the hospital. On the other hand, they are understandably worried about their legal risks.
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Parents Struggle to Contact Ethics Consultants
If they do not know the service even exists, how can patients or families ask for an ethics consult?
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Can Interactive Tools Make Informed Consent Patient Friendly?
For someone weighing whether to participate in a clinical trial, receiving a 20-page consent form can act as a deterrent. IRBs should be thinking about the consequences of information overload.
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Updated Ethics Guidance on Medical Informatics
Privacy, security, informed consent, and conflict of interest are ethical issues in healthcare that also are relevant in the health informatics field. A revised code of ethics from the American Medical Informatics Association addresses these and other concerns.
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Ethical Approaches for Accurate Patient-Reported Outcome Measures
When researchers are comparing treatments in clinical trials, proxy reports might be a useful surrogate for patients whose self-report cannot be obtained or is unreliable.
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What Happens if Post-Approval Studies Are Delayed or Do Not Show Benefit?
Essentially, the ethical issues are how to consider the interests of patients today, who are willing to accept uncertainty in the hopes a drug works because they do not have time to wait, and the interests of patients tomorrow, who would prefer to have stronger evidence about what works and what does not.
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Disclosure Needed if Physicians Own Outpatient Facilities
Physician ownership creates an inherent conflict of interest, known as “dual agency.” This means the physician has a personal financial stake that could conflict with the ethical obligation toward patient well-being.