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Patients in a minimally conscious state (MCS) demonstrate behaviors suggestive of consciousness episodically and intermittently, and because these behavioral signs are not reproducible, diagnostic errors can be quite high, says Joseph J. Fins, MD, MACP, the E. William Davis, Jr., MD, Professor of Medical Ethics and chief of the Division of Medical Ethics at Weill Cornell Medical College.
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While the field of bioethics has traditionally embraced a diversity of approaches to clinical ethics consultations, there is now a general consensus for the need to agree of some basic standards in order to evaluate the quality and impact of the service.
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More than one-third of 310 medical students surveyed had a moderate to strong bias against obese people, according to a recent study.1
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The primary ethical concern with human egg donation is that there are no long-term studies on the safety of this practice, according to Jennifer Lahl, president of The Center for Bioethics and Culture Network in Pleasant Hill, CA.
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Assessing risks and benefits is an evolving process in the human research protection world especially for IRBs that handle social-behavioral, as well as biomedical, studies. One size in risk-benefit assessment definitely does not fit all. For instance, IRBs sometimes over-emphasize risks in studies involving social-behavioral topics without considering protections that researchers have put in place, IRB experts say.
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Creating clear, truly understandable informed consent documentation can sometimes be a challenge for IRB members and researchers, particularly in the area of international research. Making sure that details are not lost in translation and that the documentation meets U.S. federal and international regulations can also present some difficulty.
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When attempting to activate a clinical trial, one of the biggest concerns an institution faces is turnaround time. At Cedars-Sinai Medical Center in Los Angeles, activation of a new clinical trial could sometimes take 118 days, including IRB review, study team response time, and non-IRB required reviews such as contract negotiations. But for some protocols, including early-stage oncology or therapeutic studies, the institution looked for other ways to bring those new therapies to patients as efficiently and safely as possible.
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As often happens in research, new rules, policies, and guidelines often follow media reports of research integrity and ethical breaches.
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IRBs might help board members improve their protocol review process through the use of a tool that guides them through questions to ask about each study.
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Technology now is driving the way informed consent documents are formatted and presented, according to an expert.
