Medical Ethics Advisor – January 1, 2024

Do Clinicians Follow Ethics Recommendations? Relationships Are Important Factor

Ethicists often make recommendations after a consult — but does anyone actually follow them?

Nursing Students Have Knowledge Gaps on End-of-Life Communication

Burnout is causing many nurses to consider leaving the field of nursing altogether, as evidenced by multiple recent studies. Lack of preparation for end-of-life care is a source of considerable stress for nursing students.

What Is Futile Care? Clinicians, Families Have Different Views

Many ethics consults involve conflicts between clinicians and families about end-of-life care. After speaking with the various parties, ethicists sometimes realize that the root of the issue is differing views of what constitutes “futile” care.

Ethicists Find that Empathy, Accurate Information Defuse Conflicts

Families may interpret the word “futile” to mean that clinicians are just giving up, that the patient is not important enough to continue the current level of care, or even that clinicians are trying to clear the bed for a more deserving patient.

Unique Ethical Dilemmas for Mental Healthcare of Infants, Young Children

Infant and early childhood mental health practitioners face complex and unique ethical issues. Experts argue that a code of ethics is urgently needed.

Ethical Input Needed for Digital Models and Simulations in Healthcare

Digital models and simulations are a quickly evolving technology that, like artificial intelligence tools, will change clinical practice and patient care.

Ethical Responses if Faculty Object to Teaching Physician-Assisted Death

Multiple recent papers focus on the ethics of conscious objection of providers participating in medical aid in dying. However, there are little to no recommendations or guidelines for conscientious objection to teaching medical aid in dying.

Ethical Decision-Making with Deprescribing for Older Adults

Physicians must consider multiple ethical issues when making decisions on deprescribing for older adults with dementia, a recent study found.

Informed Consent Practices for Acute Stroke Treatment Vary

Currently, the two cornerstones of acute ischemic stroke treatment are intravenous thrombolysis and, for patients with large vessel occlusions, endovascular thrombectomy. For treating clinicians, the question becomes: How do clinicians ensure that patients (or their surrogate decisionmakers) make an informed decision while avoiding treatment delays that can result in worse outcomes?

It Is Not Just Physicians: Residents also Receive Industry Payments

Drug and device makers publicly report all gifts made to physicians and advanced practice providers, as required by the 2010 Physician Payments Sunshine Act. Residents and other trainees are excluded from this requirement — but that does not mean these providers are not receiving payments.

Audio Assistance Improves Minorities’ Willingness to Participate in Research

Audio-assisted informed consent forms significantly improved the willingness of a sample of primarily African American patients to participate in a mock clinical trial.

Higher Mortality for Neurosurgery Patients with Pre-Existing DNRs

Neurosurgeons at University of Rochester Medicine observed that patients with pre-existing do-not-resuscitate (DNR) orders receiving cranial neurosurgery tended to have poor outcomes. To see if their clinical observations were reflected in actual data, the neurosurgeons analyzed 30,384 patients who underwent cranial neurosurgery in 2018-2020.