Medical Ethics Advisor – July 1, 2024

Can Ethicists Be Sued for Recommendations? Attorneys Warn of Potential Legal Risks

The field of clinical ethics continues to evolve, with core competencies, certification, and documentation in the electronic medical record. In a recent paper, Claudia R. Sotomayor, MD, DBe, HEC-C, chief of the Ethics Consultation Service and a clinical ethicist at Georgetown University’s Pellegrino Center for Clinical Bioethics in Washington, DC, and colleagues explored whether the professionalization of ethics consultation exposes those working in this field to the types of liability claims faced by professionals in other fields.

Some Patients Request Ethics Consults — but for Issues Unrelated to Ethics

At Memorial Sloan Kettering Cancer Center, ethicists added a “Request Ethics Consultation” button to the electronic patient portal. However, of 74 ethics consult requests made through the portal, just one involved an ethics issue. All of the other requests fell outside the purview of the Ethics Consultation Service, such as people wanting help with hospital resources or care coordination.

Effective Ethics Education in Nurse Residency Programs

While directing the nurse residency program at a large midwestern academic teaching hospital, Rebecca West, MSN, RN, NPD-BC, observed that many recent graduates were highly distressed over ethical issues. One new nurse was intensely uncomfortable with completing orders for aggressive treatment for a patient clearly in the process of dying. The nurse did not think to request an ethics consultation. West and colleagues authored a recent paper on the benefits of embedding ethics content in nurse residency programs.

Ethical Concerns if AI Tools Assist Surrogate Decision-Makers

Surrogate decision-makers are faced with a formidable task: To make decisions based on the ethical principle of substituted judgment. “The idea is supposed to be, when these surrogates are making decisions, they are not supposed to choose what they want,” says David Wendler, MA, PhD, head of the section of research ethics in the Department of Bioethics at the National Institutes of Health Clinical Center. The surrogates instead must ask: What decision would the patient make?

Ethicists Offer Unique Skills to Address Workplace Violence

For hospitals attempting to address workplace violence, the focus typically is on concrete interventions: Providing de-escalation training, adding metal detectors, or bolstering security. What is less well-understood are the ethical implications of violence.

Barriers to Ethical Informed Consent with Hereditary Cancer Genetic Testing

Demand for hereditary cancer genetic testing is increasing rapidly as the result of advancements in technology and growing awareness of the utility of testing in cancer prevention and treatment. Clinicians have an ethical responsibility to ensure patients can make a fully informed decision about undergoing genetic testing.

How Is the Ethics Service Doing? Data Are Necessary to Know

Unlike clinical areas, which are required to track a large number of healthcare quality measures, many ethics programs have little data to demonstrate their effectiveness. One reason is that assessing an ethics consult is not as straightforward as tracking the rate of hospital-acquired infections or surgical complications.

Financial Conflicts Cloud Joint Replacement Technology Study Findings

As an associate editor for an orthopaedic journal, James A. Browne, MD, noticed that an increasing number of economic analyses were being published dealing with new technologies in joint replacement. “These studies, when sponsored by industry or conflicted with financial interests, are very likely to support the sponsor’s new technology — and may be little more than a sophisticated marketing effort,” concludes Browne.

Some Hospitals Still Restrict Family Presence

Many hospitals still have not lifted restrictions on family presence during resuscitation/invasive procedures that were implemented during the pandemic, raising ethical concerns. A year out from the end of the global pandemic, it is time for family presence to be reestablished to reflect a culture of patient and family-centered care, according to an updated practice alert from the American Association of Critical-Care Nurses.

Ethical Concerns for Study Participants with Opioid Use Disorder

Individuals with opioid use disorder are a vulnerable population who face some unique risks when participating in research.