Medical Ethics
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Researchers Are Revamping Processes to Gather Community Input
Input from community members can help researchers make the study more effective by providing participants with regular updates on the results and proactively translating research consent forms into preferred languages. Investigators also could hire a staff representative of the community who can navigate cultural nuances and speak the preferred languages.
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Ethical Approaches to Address Nursing Workloads, Staffing Shortages
Ethicists can perform an invaluable role by working closely with senior management and medical staff leaders to develop collaborative initiatives to acknowledge the problem’s magnitude and engage nursing representatives in developing creative solutions.
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Informed Consent Requirements May Hinder Innovation in Stroke Treatments
IRBs and regulatory bodies should consider the changing scope of acute stroke care, and collaborate with investigators to design studies that can ethically answer important questions and allow innovation and progress in the field.
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IRBs Tend to Err on the Side of Protection, Not Inclusion
Researchers must strike a balance between protecting and including participants in their protocol design. Building in additional safeguards for those deemed vulnerable could help.
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Legal Implications if Adolescents Seek Confidential Care
Generally, emergency clinicians are required to obtain parental consent for care provided to minors. However, there can be exceptions if the minor is seeking treatment for sexually transmitted infections, mental health, substance use disorders, sexual assault, or pregnancy. Several federal and state laws apply. Healthcare professionals are advised to be aware of the laws where they practice.
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Fraud Allegations Involving Alzheimer’s Disease Study Raise Concerns
In a paper published in 2006, the authors provided evidence indicating accumulation of a specific form of beta-amyloid protein was a cause of Alzheimer’s disease. However, recent accusations suggest images allegedly were altered, raising doubts about the initial conclusions. Regardless of what happened, this case has jumpstarted a conversation about instituting more preventive measures, conducting faster investigations into fraud allegations, and levying more severe consequences for researchers found guilty of misconduct.
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Ethicists Asked to Weigh in on Medical Necessity of Abortion
If ethicists are asked to weigh in, they should suggest a second medical opinion (if time permits) and encourage the institution to clarify any legal questions, ideally before there is an emergency. Institutions also should assure clinicians they will have support from the ethics committee in the event of overzealous prosecution.
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New Requirements Are Discouraging Physicians from Writing DNR Orders
Ethicists should help develop related protocols. For practitioners, code status conversations should be treated with the seriousness of surgery. That means involving the right people and taking the time to ensure medical understanding and prognosis, as well as patient values and goals, before talking about a care plan. When possible, practitioners should bring up DNR at the end of a meaningful conversation.
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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.