Medical Ethics
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Medical Crowdfunding Is Not Providing a Proper Safety Net for the Neediest Patients
While safety nets are supposed to catch everyone in need equally, crowdfunding can be more effective for some people than others. People in states with more uninsured populations, worse poverty, and higher rates of medical debt are more likely to try to raise funds, but are less likely to succeed.
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CDC Tries Less Rigid Approach to Opioid Prescribing Guidelines
Agency underscores voluntary nature of its recommendations, highlights new science and collaboration that went into the revisions.
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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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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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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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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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Adults with Developmental Disabilities at Risk for Poor End-of-Life Care
Policies should specify that the wishes of these patients should be known. They should be able to access all medically appropriate care, without bias, and have the right to avoid medical interventions they wish to refuse.
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‘Informed Assent’ for CPR Is Reasonable Approach for Some Hospitalized Patients
This concept was developed to satisfy the right of physicians to initiate DNR orders in futile situations and their duty to communicate to patients and lawful surrogates. Through informed assent, physicians state they will write a DNR order because it would be futile and harmful to the patient to attempt CPR in their current serious illness.
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Decision-Making Capacity Is Concern for Older Study Participants
It likely is an accident if investigators enroll participants lacking decision-making capacity in trials. Since capacity to consent is not a mandated area to report for most journals publishing research, it may be left out for space or other reasons. Nevertheless, some researchers are seeking to start a conversation about this.
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Shared Decision-Making Is Ethical Balancing Act for Clinicians
Physicians should always inform, usually recommend, sometimes attempt to persuade — but never manipulate or coerce.