Medical Ethics Advisor – June 1, 2023

The Joint Commission’s Updated Ethics Standards Spark Debate

The Joint Commission could play a role in elevating the professionalism and value of ethics programs nationally with some enhanced standards, encouraging formal attention to best practices and evaluation — and evolving toward the possibility of more rigor over time.

Ethics Work Affects Entire Hospital: Data Can Prove It

Ethics work aligns with many issues that are top of mind for hospital leaders. How can ethicists measure that?

Nurse Champion Role Helps Identify Ethics Issues

With the right training and advocacy, nurses can identify and address ethical issues, along with moral distress. They might be more willing to speak up about ethical issues encountered in daily practice and identify institutional resources to assist.

Magnet Program Emphasizes Ethics in Patient Care

Ethics is included in the program’s foundational items, which must be in place for the hospital to be certified as a Magnet hospital. The organizational overview requirement mandates the hospital to create policies and procedures that address patient ethical issues.

Advance Care Planning Can Lower Odds of Aggressive End-of-Life Treatment

Advance care planning was associated with significantly lower odds of indicators of aggressive end-of-life care (i.e., hospital death, hospital admissions, intensive care, delayed hospice referrals, and chemotherapy). Cancer patients who engaged in advance care planning were 50% more likely to complete Do Not Resuscitate orders compared to cancer patients without an advance directive.

Is Death Imminent? Conflicts Occur if Clinicians Do Not Make It Clear

Poor communication on prognosis prevents the family from making decisions based on the true situation. If surrogates do not realize death is imminent, they cannot plan for hospice care or contact family members to be there for the patient’s last moments.

Ethical End-of-Life Care for Homeless Patients

Clinicians should acknowledge their own potential bias and avoid using language in the medical record that is stigmatizing. Also, they can request an ethics consult before making any decision to not provide care for a patient experiencing homelessness.

Lack of Transparency on Informed Consent Documents Complicates Oncology Trials

Researchers should describe the potential benefits and risks of participating in the trial compared with potential benefits and risks of receiving standard treatment outside the trial. Also, strive to write consent forms that highlight the key issues involved in the decision to join a trial.

Ethical Misconduct Is Main Reason for Retracted Autism Studies

There have been quite a few retractions of studies in the past few years as it has become easier to automatically scan for faulty or manipulated data. There is a concern the pressure to publish can lead a small group of scientists to commit fraud rather than pursue the truth. Overall, this remains a fairly uncommon occurrence, but any fraud is disturbing.

Did Study End Early? There Is an Ethical Obligation to Participants

Research participants consent to take on risk for the benefit of others, not for their own benefit. If a trial ends prematurely, researchers should tell participants. Investigators also must ensure any risks participants accepted are mitigated to the fullest extent possible.