Medical Ethics
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Whistleblower Exception Allows Reporting HIPAA Violations with PHI
Healthcare professionals can find themselves in a quandary when they want to report fraud or other concerns within their organizations because doing so could require disclosure of protected health information. That could seem like a HIPAA violation; fortunately, there is a whistleblower exception that covers this scenario.
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Exploitation Issues Arise in Study of Human Subject Incentive Payments
As IRBs review participant incentives for studies, they assess whether the incentives are coercive or exploitive. New research provides a snapshot of the diversity of these incentive offerings, revealing monetary payments for biomedical studies tend to be 10 times higher than payments for sociobehavioral studies. -
Pfizer and Moderna Begin COVID-19 Vaccine Trials in Younger Children
Both Pfizer-BioNTech and Moderna announced in March they had begun clinical trials of their COVID-19 vaccines in children younger than age 12 years. Although public reaction was mixed, researchers and bioethicists now say the timetable for a pediatric vaccine and for the United States to possibly reach herd immunity is early 2022. -
White Adults, Women Overrepresented in U.S. Vaccine Trials
Investigators uncover reporting gaps, lack of proper representation for older adults, minority groups.
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Ethical Responses Needed if Clinicians Say Discharge Is Unsafe
For some patients, there are no caregivers at home. Others may be living in unsafe conditions. Ethicists can help by brainstorming scenarios, and trying to connect resources accordingly.
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Novel Program Decreases Transport to ED for Hospice Patients
Ventura County, CA, paramedics underwent 30 hours of training on crisis counseling, grief, and palliative care. When EMS responded to a 911 call and determined a patient was in hospice, they contacted trained staff. During a three-year study period, the percentage of hospice patients transported to the ED was 36% in the first year, 33% in the second year, and 24% in the third year. This was compared to 80% of hospice patients transported, on average, during the six months before project implementation.
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No Evidence of Bias on Pediatric Ethics Rounds
Researchers compared sociodemographic factors between patients admitted to an academic children’s hospital during ethics rounds in the PICU, PCTU, and NICU in 2017 and 2018 who were identified as having ethics issues and all other patients admitted to those same units during the same period. The researchers expected racial and/or socioeconomic differences between the groups, with socially vulnerable patients disproportionately identified as having ethical issues on rounds. But they did not find this to be the case.
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Some Code Status Discussions Are Rushed, Incomplete, or Misleading
Learning how to engage in code status conversations is as important as learning how to perform medical procedures. Clinicians would not ask patients in completely neutral terms whether they want a procedure that has no chance of working or would inflict serious harm. Any conversation around resuscitation status should take into account patients' goals and values, what is important to them in life, and the minimum acceptable quality of life.
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Challenges with Surrogate Informed Consent
The central ethical question is whether a surrogate’s judgment for consenting or refusing a medical intervention on behalf of a patient is consistent and congruent with this patient’s preferences, interests, and values.
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Is It a Problem to Pay Research Participants?
Paying people to participate in clinical research can be seen as ethically problematic. Yet community members expressed the opposite view, according to the results of a recent study.