Medical Ethics Advisor – March 1, 2025

Updated ANA Code of Ethics Reflects Today’s Realities; for Ethicists, it Is Another Tool

Every 10 years, the American Nurses Association updates its Code of Ethics for Nurses. The much-anticipated 2025 changes have important implications for nurses, ethicists, and other healthcare providers.

Pediatric Ethics Consults Adhere to Some — But Not All — National Standards

Core competencies for ethics consultation were established in 2011 by the American Society for Bioethics and Humanities. However, it is unclear if ethics consultants are consistently meeting these standards.

Religion and Spirituality Course Content Varies in Graduate Bioethics Programs

Almost a decade ago, Cynthia Geppert, MD, PhD, DPS, adjunct professor of bioethics at the Alden March Bioethics Institute at Albany Medical College, noticed that few graduate bioethics programs included a course addressing religion and spirituality. This realization led to Geppert co-developing a religion and bioethics course in 2018.

Stakeholder Engagement Is Important in Palliative Care Research

Involving stakeholders in palliative care research promotes successful recruitment, data collection and analysis, and dissemination of study findings. However, researchers face many challenges in doing this effectively.

Training Is Needed as Palliative Care Moves to Home Health Setting

There is growing awareness of the need to integrate palliative care in the home health setting. However, two important ethical questions remain unanswered. Is the home health care workforce ready to deliver palliative care? And are home health patients ready to accept palliative care?

Seriously Ill Patients Have Unmet Needs at Discharge

Aaron A. Kuntz, MD, a palliative care physician in the Division of General Medicine at Beth Israel Deaconess Medical Center, wanted to better understand patient and caregiver experiences with the hospital discharge process. The researchers interviewed 11 patients and four caregivers who received palliative care during a hospitalization. The patients and caregivers described lack of clarity on the next steps and needing more education on post-discharge services.

Not Just Clinicians: Research Staff Experiences Moral Distress, Too

When ethicists encounter a concern about “moral distress,” it often comes from a nurse who feels aggressive end-of-life care is not in a patient’s best interest. But what about a researcher who feels enrollment in a clinical trial is not in a patient’s best interest?

Participants in Cancer Trials Weigh Multiple Benefits and Burdens

When deciding on whether to participate in a cancer clinical trial, a patient may want to help others while at the same time hoping for a cure and worrying about lack of transportation.

Residents Lack Conflict Management Skills, Raising Ethical Concerns

Chinedu Okoli, MBBS, and colleagues surveyed 65 resident physicians and interviewed 15 resident physicians to learn more about the conflicts residents encounter and how those conflicts are addressed.

Decision-Making Capacity of Psychiatric Patients Is Ethically Complex

Clinicians often have difficulty assessing decision-making capacity in psychiatric patients. One reason is that capacity can fluctuate based on the patient’s condition or treatment.

Social Determinants of Health Affect Caregivers’ Coping Strategies

Caregivers with poor coping skills may struggle with stress, anxiety, and depression — all risk factors for poor health outcomes. Caregivers facing higher social determinants of health risks (such as limited financial resources or lack of access to quality healthcare) may have diminished capacity to cope with stressors.

Advance Care Planning Boosted with Machine Learning Models

Patients who engage in advance care planning conversations are more likely to receive end-of-life care consistent with their wishes. A major challenge is accurately predicting when a patient is near the end of life. This is an area where machine learning models can help.

Who Is the ‘Correct’ Decision-Maker? Legal, Ethical Definitions May Conflict

From an ethical standpoint, it may be clear to everyone concerned that a particular individual is the correct surrogate decision-maker. However, from a legal standpoint, it can be a different story.

Ethical Concerns if Surrogates Report Decisional Conflict

Surrogates face challenging decisions on life-sustaining treatments in the intensive care unit setting. Those with decisional conflict reported poor medical understanding, suboptimal support, and lack of clarity about patients’ treatment preferences.

Policies for Vulnerable Research Participants Vary at U.S. Academic Institutions

When conducting clinical trials involving vulnerable participants, researchers are ethically and legally obligated to protect them from harm. But what policies do academic institutions have for protecting vulnerable human research subjects?

Researchers Face Many Ethical Challenges with HEALthy Brain and Child Development Study

The HEALthy Brain and Child Development study is looking at the effect of various prenatal and postnatal exposures on pediatric brain and behavioral development. To answer important questions about early life influences on developmental trajectories, researchers are recruiting a large cohort of pregnant individuals. Some participants have substance use disorders.