Medical Ethics Advisor
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“Don’t worry about the cost” doesn’t reflect patients’ reality
"Don’t worry about the cost. All that matters is getting you well.” Well-meaning physicians frequently say this, but in fact, patients have good reason for wanting to know what care will cost them.
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Ethical controversy erupts over minors’ autonomy
In the controversial “Cassandra C” case, a 17-year old Connecticut girl diagnosed with Hodgkin’s lymphoma was ordered by the state Supreme Court to undergo chemotherapy against her will. The girl refused further treatment after undergoing surgery to remove a lymph node, but as of press time is being kept in a hospital room under court order.
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Evidence of economic burden of disparate care for minorities continues to grow
A recent tragic case involving informed consent obtained from parents with limited English proficiency led to a successful lawsuit against the hospital. The parents were told the risks of surgery for their child included kidney damage, but there was no interpreter in the room.
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Study validity may be compromised if patients drop out
Occasionally, individuals who agreed to participate in a research study withdraw for various reasons; some simply stop participating without communicating with investigators.
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Surprising data on FDA committee members’ financial ties
Food & Drug Administration (FDA) advisory committee meetings have, on average, 13% of members with financial conflicts of interest, according to a recent study. Researchers analyzed financial conflicts of 1,400 advisory committee members over a 15-year period.1
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Innovative program effectively educates nurses on clinical ethics
A Clinical Ethics Residency for Nurses has been developed at two large northeastern academic medical centers. One goal is to teach nurses how to be effective advocates for patients whose circumstances, problems, and treatments are ethically complex.
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Ensure patients’ wishes are respected through surrogate decisionmakers
A recent ethics consult at The Ottawa Hospital in Ontario, Canada involved a victim of domestic violence. “The challenge was that the husband, who had severely beaten the patient, was the patient’s substitute decisionmaker,” recalls Thomas Foreman, DHCE, MA, MPIA, director of the Department of Clinical and Organizational Ethics. -
IOM: End-of-Life Care is Inadequate in the US
The American healthcare system is poorly equipped to care for patients at the end of life, according an Institute of Medicine report.
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Palliative care hardwired into hospital system
Palliative care isn't just for hospice patients; it also is used to manage the symptoms of those with chronic or advanced illnesses. One hospital system in Michigan has brought palliative care into all aspects of hospital care for all patients. -
Data collection comes to palliative care
Palliative care was only recognized as a specialty five years ago by the American College of Graduate Medical Education. Because of its newness, those working in the specialty are still learning how to effectively collect data and make use of the information once they have collected it.