Medical Ethics Advisor
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Some IRBs Expand Their Purview to Consider Scientific Merit
The most common ethics-related reasons for protocol deferral were inadequate informed consent, insufficient protection of participants’ safety, inadequate detail of risk assessment, and inadequate minimization of risks. Some study protocols were not approved due to issues of scientific merit, such as adequate adverse event reporting or the importance of the knowledge to be gained. Read on to learn how to prevent these problems and avoid delays.
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Court-Appointed Guardians for Unrepresented Patients
Ethicists are seeing a range of issues arise during consults involving unrepresented patients, including conflicts over how aggressive treatment should be, whether to treat at all, how to discharge, and how to follow up with compliance with treatment. Creating a template for actions to take related to unrepresented persons who present to the hospital is a proactive first step.
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Making Ethical Decisions on Genetic Testing, Precision Medicine
Physicians are obligated to consider the benefits and harms of genetic testing. They must be prepared to engage in discussions with patients, and offer assistance in understanding the risks, benefits, and uncertainties of direct-to-consumer genetic testing. Clinicians must safeguard privacy, security, and confidentiality of patient information.
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Ethicists Strive to Make Training for Consults More Consistent
Hospital administrators vary in their awareness of the need for training for ethics consultants. They want to believe the committee is doing good work. But as ethics committees often do not capture metrics to measure their work product quality, it is hard for leaders to question the training quality.
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Encourage Reluctant Clinicians to Contact Ethics
Ethicists can contact department chairs and clinical leadership to express interest in participating in grand rounds or educational forums. Contact nursing leaders to offer in-service training sessions on frequently encountered ethical issues. Join hospital committees to learn more about ethical issues clinicians are encountering. The idea is to gain the support of individual clinicians, the medical staff, and hospital leaders.
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Updated Recommendations on Pediatric End-of-Life Care
A report includes a review of essential elements of care for patients and families. The authors covered discussions on goals of care, how to establish end-of-life care goals, advance care planning, and palliative and hospice involvement.
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Nurses and Physicians Find Ethics Consults Helpful, But for Different Reasons
Ethicists are challenged to meet the needs of everyone involved during an ethics consult. Now, ethicists can turn to some new data on how those differ.
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Electronic Orders, Education Boost Requests for Ethics Consults
The electronic order is an important way to streamline ethics consultation requests, but additional, broader efforts will be needed.
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The Trouble with Electronically Tracking Study Medications
Digital pills allow data to be recorded automatically about patients’ medication adherence, but patients and providers have expressed significant ethical concerns.
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Financial Conflicts Reported Inconsistently
It might be time to consider another approach to transparency on financial conflicts.