Medical Ethics Advisor – November 1, 2022

Artificial Intelligence Soon Could Transform the Field of Clinical Ethics

Using a tool that could introduce bias into a clinical situation or during an ethics consult is problematic. To address these and other issues, ethicists can and should be part of their facility's artificial intelligence oversight board.

Researchers Overlook Unintended Consequences of Health Technology

Health technology studies usually cover research ethics related to conducting the study. However, paper authors often seem to omit details about the ethical implications of the technology itself. This gap is important to consider in an era of dramatically advancing technology.

Shared Decision-Making Is Ethical Balancing Act for Clinicians

Physicians should always inform, usually recommend, sometimes attempt to persuade — but never manipulate or coerce.

Decision-Making Capacity Is Concern for Older Study Participants

It likely is an accident if investigators enroll participants lacking decision-making capacity in trials. Since capacity to consent is not a mandated area to report for most journals publishing research, it may be left out for space or other reasons. Nevertheless, some researchers are seeking to start a conversation about this.

‘Informed Assent’ for CPR Is Reasonable Approach for Some Hospitalized Patients

This concept was developed to satisfy the right of physicians to initiate DNR orders in futile situations and their duty to communicate to patients and lawful surrogates. Through informed assent, physicians state they will write a DNR order because it would be futile and harmful to the patient to attempt CPR in their current serious illness.

Adults with Developmental Disabilities at Risk for Poor End-of-Life Care

Policies should specify that the wishes of these patients should be known. They should be able to access all medically appropriate care, without bias, and have the right to avoid medical interventions they wish to refuse.

Researchers Are Revamping Processes to Gather Community Input

Input from community members can help researchers make the study more effective by providing participants with regular updates on the results and proactively translating research consent forms into preferred languages. Investigators also could hire a staff representative of the community who can navigate cultural nuances and speak the preferred languages.

Ethical Approaches to Address Nursing Workloads, Staffing Shortages

Ethicists can perform an invaluable role by working closely with senior management and medical staff leaders to develop collaborative initiatives to acknowledge the problem’s magnitude and engage nursing representatives in developing creative solutions.

Informed Consent Requirements May Hinder Innovation in Stroke Treatments

IRBs and regulatory bodies should consider the changing scope of acute stroke care, and collaborate with investigators to design studies that can ethically answer important questions and allow innovation and progress in the field.

IRBs Tend to Err on the Side of Protection, Not Inclusion

Researchers must strike a balance between protecting and including participants in their protocol design. Building in additional safeguards for those deemed vulnerable could help.