Medical Ethics Advisor – August 1, 2023

Task Force Aims to Grow HEC-C Program

The Healthcare Ethics Consultant-Certified (HEC-C) designation is advancing the overall professionalization of the field of ethics. The certification advances the quality of ethics consultations and puts ethicists on a level playing field with clinical counterparts.

Ethicists View HEC-C as One Step Toward Professionalization

The demand for ethics work is rising, but most individuals who conduct consults are clinicians who work as volunteers. Leaders must identify and address all kinds of ethical issues, which requires employing the right people with relevant and specific knowledge and skills.

Ethicists Hold Debriefings After Critical Patient Events

In the emotionally charged, fast-paced ICU, clinicians are faced with death and dying daily. Engaging in open, honest communication about these situations will help build a moral and ethical community.

ICU Staff Report Severe Moral Distress, But Resources Are Underused

Unresolved ethical concerns not only cause individual moral distress, but can also change the staff relationships and clinical cohesiveness.

Ethical Guidance for Research on Dying or Recently Deceased ICU Patients

There are no authoritative international ethical guidelines governing research on dying or recently deceased individuals. A group of investigators sought to start a conversation about challenges and potential solutions. They developed a preliminary framework for the ethical conduct of research with imminently dying patients.

For Clinicians, Discharge Safety Is a Growing Ethical Concern

Clinicians are asking if a discharge is plan ethical, indicating distress over what they consider to be unsafe discharges. Healthcare providers create a treatment plan based on what they believe is in the patient’s best interest. For various reasons, sometimes the plan is just not feasible.

Ethical Discharge Planning for Victims of Violence

Decision-making in these cases always is going to be somewhat subjective. Physicians must rely on clinical judgment, along with available resources and information. What is important is to make the decision using an ethical framework.

Viewing Social Media Posts About Ongoing Care Could Harm Patient-Physician Relationship

Clinicians might be motivated to understand the patient’s home life better, to see how the healthcare team is portrayed, or just simple curiosity. Regardless, the clinician’s goals in viewing the content likely can be better achieved by speaking directly with the patient or family.

Was Resident Involved in Surgery? Some Patients Are Not Informed

Further efforts are required to improve communication and education regarding resident involvement in surgery, and address patient concerns and preferences more effectively to protect the physician-patient relationship.

Community Members Help Train Research Staff

At Tufts Clinical and Translational Science Institute, research staff learn how to provide informed consent by working with community members acting as simulated prospective study participants in role-playing exercises. More than 40 community members, researchers, patients and families, and healthcare providers offer feedback and help develop training.

Real-Life Experience Allows Researchers to Obtain Ethical Consent

Research staff may have secured a signed consent form from a study participant, but did they obtain that consent ethically? People considering whether to join a clinical trial may not fully understand the procedures involved, risks and benefits, confidentiality issues, or even that participation is voluntary, depending on how the research is presented.

For Some Ethics Programs, ‘Tele-ethics’ Is Routine

Sustainable development of virtual consultation platforms, funding, training of ethics consultants, and visibility of virtual clinical ethics consultation are priorities.