Medical Ethics Advisor – September 1, 2023

High-Intensity End-of-Life Care Remains the Default at Hospitals

Ethicists can help by assisting in developing hospital policies and crafting ethics committees in a way that does not pose unnecessary bureaucratic challenges or prevent physicians from acting in the patient’s best interest.

Ethicists Often Called to Resolve Conflicts Over Aggressive Care

Quality, compassionate communication with families is critical to prevent further escalation of conflict and to preserve trust in the therapeutic relationship.

Highly Publicized Research Fraud Erodes Public Trust

There is not much IRBs can do to spot misconduct or fraud in clinical trials. IRBs do not typically review data. However, IRBs should promote compliance with legal and ethical requirements, and deal with suspected noncompliance in a fair, reasonable, and timely fashion.

Initiative Raises Organ Referral Rates, Expands Donor List and Transplanted Organ Supply

An individual’s organ donation wishes should be part of their holistic care plan. Ethicists could provide education to clinicians on this point. A culture of trust between the patient community, clinical care providers, the transplant program, and the organ procurement organization is necessary. This takes years to build — and one bad case to break.

Many Ethical Considerations if Surgeons Record Procedures

Ideally, the surgical team uses the recordings in conjunction with quality improvement and risk management to assess efficiency, professionalism, communication, and leadership. The ethics of video recording should be integrated into graduate and continuous education modules.

Ethicists Are Finding Ways to Meet Needs of Rural Clinicians

For many smaller hospitals or health systems, it is simply impractical to hire an ethicist. The Rural Wisconsin Health Cooperative pools the resources of smaller hospitals. Meetings target areas in which expertise may be lacking at each hospital, including clinical ethics.

Ethical Approaches to Informed Consent for Genetic Testing

Participants should understand what the test is for, why, what could be found, what type of information will be returned to them (and how), what resources will be available for any needed follow-up care, what will happen to their data, the point of the research, and potential for data to be used in future research.

Ethicists Are Addressing Social Determinants of Health

Hospitals and health systems should do more to address social determinants of health to meet an ethical obligation to improve community health. Ethicists can collaborate with clinicians and social workers to find solutions. Considering the complexity of such issues, it may be unrealistic to develop effective interventions immediately. But an ethics consult is a good starting point.

Ethics Involvement Is Needed with Medical Artificial Intelligence

Ethicists can help research, design, develop, and implement artificial intelligence programs at the administrative or practice levels.

Pediatric Hematology/Oncology Trainees Want Ethics Expertise

Ethics education would not replace the option or need to obtain a formal ethics consultation. However, such education could lead to fewer cases during which specialists believe they need such assistance.