Medical Ethics Advisor – May 1, 2023
May 1, 2023
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Lack of Funding, Salary Support for Ethics Consultation Work
Demand for ethics consults is rising, but there is not enough financial support, nor enough staff with specialized training in bioethics. Without commitment and active engagement from leadership, clinical ethics consultants most likely will remain almost poorly resourced, albeit with dedicated volunteers.
Failure to Report Study Findings in Timely Manner Erodes Public Trust
Further, this can contribute to bias in the scientific knowledge base, limit the ability of future investigators to build on knowledge generated from prior research, and lead to duplication of research efforts and misuse of scarce resources.
New Ethical Guidance on End-of-Life Nutrition Therapy
The guidance is intended to help clinicians understand what medically assisted nutrition and hydration can and cannot accomplish for different groups of patients.
Ethicists Can Resolve Conflicts Over Nutrition Therapy at End of Life
When deciding whether to administer, withhold, or withdraw end-of-life nutrition and hydration therapy, ethicists can help clinicians, patients, and families reach an equitable agreement.
Ethicists’ Role if Clinicians Disregard Documented End-of-Life Wishes
Early involvement of the ethics team can be helpful. After an initial assessment, the healthcare team should arrange a family meeting with surrogates, clinicians, the ethics team, social workers, and other appropriate individuals (e.g., clergy). This should happen as soon as possible, no later than the following day. The ethics team should facilitate an honest and compassionate discussion about the plan to best honor the patient’s end-of-life decisions.
Wrongful Prolongation of Life Suits Persist, Even When a Patient’s Status Was DNR
Regardless of training or good intentions to preserve life, at the end of the day, this is the patient's choice.
Living Donor Liver Transplant Raises Multiple Ethical Questions
Living donor liver transplantation could save more lives, but a lack of public awareness about the procedure, the lack of qualified surgeons available to perform the operation, and fears about the donor's long-term health all are obstacles to expansion.
Use Caution When Leveraging Exception from Informed Consent Rule
The exception from informed consent (EFIC) regulation requires public engagement. This means researchers must publicly disseminate the details of their trials before they are finished and publish the results when the study is completed. Despite these requirements, there is lack of transparency about EFIC trials.
Personal Connections Are Crucial When Recruiting from Underrepresented Groups
Research findings that are not representative of the entire population perpetuate disadvantages to minoritized groups. Community members can advise research teams about messaging and perceptions that might undermine investigators’ ability to successfully recruit participants from diverse racial and ethnic backgrounds. A lack of trust in medical research results in many people declining to participate in clinical trials.
Inconsistent Transparency on Physician Sexual Misconduct Allegations
Medical boards are not consistently transparent on physician sexual misconduct, even two years after the Federation of State Medical Boards released a policy calling for such.