Medical Ethics Advisor – June 1, 2024
June 1, 2024
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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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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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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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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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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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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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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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Ethical End-of-Life Care Discussions in ICUs
Intensive care unit clinicians experience multiple barriers to quality end-of-life care conversations, a recent study found.
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Ethics Concerns if Patient Currently Is (or Previously Was) Incarcerated
Unique ethical issues come up with individuals who currently are (or previously were) incarcerated or whose surrogate decisionmaker is incarcerated, a recent study found.
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Unique Ethical Concerns with Informed Consent for Psychedelics
The use of psychedelics in psychiatric care raises multiple challenging ethical issues.
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Most Financial Conflicts of Radiology Guideline Authors Are Undisclosed
Even though the federal Physician Payments Sunshine Act was enacted more than a decade ago, misconceptions persist as to its requirements.
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Electronic Order Set Facilitates Treatment Withdrawal
At OhioHealth, an electronic order set is used to facilitate withdrawal of life-sustaining treatment.
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Ethical Obligations if Patients Have Limited English Proficiency
As a nurse and clinical bioethicist, Melissa Kurtz Uveges, PhD, MA, RN, had a strong desire to facilitate communication with patients with Limited English Proficiency and to provide information in their preferred language.