Medical Ethics Advisor – June 1, 2014
June 1, 2014
View Archives Issues
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Patients’ end-of-life wishes often not included in EHRs
Electronic health records (EHRs) often do not contain advance directives, documentation of the advance care planning process, or other information that can help guide decision-making at the end of life. -
All families of potential donors aren’t offered opportunity
The primary ethical consideration when approaching families for organ donation is to ensure that the donation authorization process is voluntary and that it respects the wishes of those who want to donate. -
Discussions often don’t occur on use of sedation at the end of life
While most Dutch respondents to a 2011 survey indicated that they initiated open discussions about sedation proactively, American respondents reported fewer such discussions, with most occurring late in the dying process. -
Public disclosure linked to far fewer payments to physicians
Patients will soon be able to access information about their physicians financial relationships, as a result of The Physician Payment Sunshine Act. It is unclear how this information will affect the patient-physician relationship. -
Quality of palliative care training, bedside tools reduce end-of-life ICU use
The quality of palliative care training in critical care medicine programs and the use of bedside tools were independently associated with reduced intensive care unit (ICU) use at the end of life. -
New recommendations on how to ethically manage findings
All practitioners should anticipate and plan for incidental findings so that patients, research participants, and consumers are informed ahead of time about what to expect, and so that incidental findings are aptly communicated if they are found, according to a report from the Presidential Commission for the Study of Bioethical Issues. -
PC measures must be applicable across variety of illnesses, settings
Palliative care clinicians have been challenged to find measures of quality that are applicable to all patients in a variety of settings. -
"Disclosure gap" remains, despite overall trend toward transparency
Disclosure after medical errors is still not done consistently, partly due to clinicians continued concerns regarding liability exposure.