Medical Ethics
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Ethical Guidance Needed if Researchers Identify Diagnostic Errors
Clinicians know there is a clear ethical obligation to disclose errors to patients. However, the individual who finds a diagnostic error may not be a clinician in direct contact with the patient. Instead, it might be a researcher who is reviewing a chart long after a patient was discharged. What are researchers’ ethical obligations if they find an error no one else had discovered?
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End-of-Life Care Should Not Vary Depending on Provider
Clinicians must be careful about imposing medical staff priorities over patients’ priorities. Making presumptions is dangerous. Ethicists can help by explaining the provider’s responsibility to offer accurate information.
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Genomic Results by Mail Might Leave People with More Questions Than Answers
Genomic results may oversimplify complex concepts, and patients may be without clinical experts who can properly fill in the gaps.
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Physicians Reported Moral Distress About Surrogate Decision-Makers
Parties clash regarding comfort levels and how aggressive treatment should be. The lack of advance directives for so many patients exacerbates the problem. Nurses and other colleagues can join the conversations to assist or outright substitute for physicians who are unwilling or unable to engage deeply.
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Communicate Collaboratively Before End-of-Life Care Conversations Disintegrate
Once communication breaks down, it is difficult to rebuild. Clinicians, ethicists, and palliative care all should be talking to each other to be sure the family hears a common message.
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Families Are Confused, Skeptical About ‘Inappropriate’ Treatment
Many, if not most, ethics consults involve conflicts over withdrawal of life-sustaining treatment at the end of a patient’s life. Yet families are likely to be quite confused by commonly used terms such as “futile” and “potentially inappropriate.”
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American Heart Association Calls for End to Structural Racism
Group “declares its unequivocal support of antiracist principles” in a recent presidential advisory.
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Neurotechnology Takes Human Research Ethics to New Frontiers
It is possible that any IRB might someday review a study that involves making healthy people smarter, cognitively faster, and more resilient mentally. Neurotechnology, including research funded by the government, also is designed to help people with Parkinson’s disease, locked-in syndrome, mental illness, and other issues. But it could take things a step further for people with no chronic conditions. This potential raises ethical questions.
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Tips for Reopening or Closing Research Studies
The 2020 landscape for clinical trials looks different than it did five or 10 years ago. Even before the worldwide disruption in research from the COVID-19 pandemic, there were systemic shifts that have squeezed trials in ways that add pressure to investigators and IRBs.
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IRBs Look at How to Get Through Pandemic — and Beyond
As human research protection programs and IRBs enter the next leg of the COVID-19 pandemic, they can draw on experience to find the best balance between safety and efficiency. Each institution and IRB will face its own challenges. But one of the more common challenges as the United States copes with more than eight months of the crisis is pandemic fatigue and burnout.