Medical Ethics Advisor Medical Newsletter

New Approaches to Improve Medical Trainees’ Ethical Confidence

Medical trainees often lack confidence in applying ethical principles. Programs such as RISE use case-based learning, role-play, and simulations to build skills. Tools such as Pedi-EPAT assess ethical reasoning, emphasizing structured feedback and practice to prepare clinicians for complex decisions.

Ethical Concerns if Researchers Fail to Meet Recruitment Targets

Under-enrollment in clinical trials raises ethical issues, including inconclusive results and wasted participant risk. Strategies such as research navigators and extended-hour recruitment improve enrollment and diversity, ensuring trials answer critical questions and uphold obligations to participants and society.

Ethical Challenges with EFIC Studies

Exception from Informed Consent (EFIC) allows emergency research without prior consent but raises ethical concerns. Best practices include rigorous protocols, community engagement, and digital consultation tools to balance patient rights with advancing care in time-sensitive, high-risk scenarios.

Ethical Concerns Surround Accessibility and Documentation of Advance Care Plans

Advance care planning often is lacking, especially among marginalized groups. Values-based conversations, standardized documentation, and clinician prompts improve planning. Clear workflows and education help ensure patient wishes are honored, reducing conflicts and ethical dilemmas during critical care.

Ethical Considerations if Patient Undergoing Surgery or Invasive Procedures Has DNR Order

Managing do-not-resuscitate (DNR) orders during surgery is complex. Guidelines stress patient autonomy and preoperative discussions. Misinterpretation of DNR can lead to under-treatment. Structured workflows, education, and ethics consults help align care with patient goals while minimizing perioperative risks.

Research Ethics Boards/IRBs May Have Gaps in Expertise

Institutional review boards often lack specialized expertise for emerging research areas. Solutions include recruiting diverse members, using consultants, and ongoing training. Boards must ensure protocols justify risks, uphold ethical principles, and adapt to new technologies while maintaining participant protections.

Ethical Considerations of Electronic Consent in Stroke Clinical Trials

eConsent improves trial enrollment, efficiency, and diversity by enabling remote participation and reducing burdens. Ethical benefits include timely interventions and broader representation. Barriers remain, but adoption can accelerate research and enhance equity in stroke care and beyond.