Medical Ethics Advisor – January 1, 2022
January 1, 2022
View Issues
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Excluding People with Serious Mental Illness from Research Is Ethical Problem
With current treatment methods, many individuals with serious mental illness function well, maintain employment, hold valued roles in their communities, and can consent to and participate in research.
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Patients Can Request Ethics Consults, But Almost None Do
In a recently published paper, the authors reported if patients are empowered to ask for ethics consults, it can mean more patient-centered care, better shared decision-making, and a stronger patient/physician relationship.
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Informed Consent Challenges with High-Risk Surgery
There appears to be room for improvement when it comes to surgeons talking with patients about shared decision-making and providing specifics about quality of life after procedures.
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New Data on IRB Members’ Perceptions of Violations
Failure to properly store data and neglecting to maintain project records are the two most common IRB violations, according to a recent survey of 242 faculty members at research-intensive universities in the United States.
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Screening Tests to Determine Study Eligibility Are Not Foolproof
IRBs and researchers should expand eligibility criteria to diversify representation, remove extraneous inclusion/exclusion criteria, and eliminate some screening tests if they are not strictly necessary, particularly tests that produce many false-negative or false-positive results.
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Researchers Can Remove Recruitment Barriers in Alzheimer’s Trials
What can be consolidated, made simpler, or translated? What data can be collected outside your research setting? How can you communicate better with prospective and current research participants?
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Single IRB Concerns Include IT Limitations, Process Variations
Consistency, standardization, speed and efficiency, and simplification are reported benefits. Challenges include timeliness of the research review process, insufficient communication, and uncertainty at local institutions.
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Notification Practices Vary for Emergency Research, Few Participants Withdraw
Find consent processes that protect and preserve patients’ autonomy to the extent possible, while also allowing medical progress to occur and giving participants access to potentially beneficial therapies. Doing so may require
a more creative process than just following the rules. -
Ethical Considerations When Nurses Perform ‘Slow Codes’ at End of Life
On some occasions, limited resuscitation efforts occurred without the family’s knowledge. Not all resuscitation measures are medically beneficial, and clinicians often must decide in the moment if they are clinically appropriate to perform.
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Infectious Complications Carry Ethical Implications for End-of-Life Care
Many assume antibiotics are a simple solution to infectious complications, which is not always the case. Clinicians must explain the downstream effects of traumatic injuries and ICU care to families in detail so they can see how each bump in the road will affect the patient.
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Medical Residents Know Little About Surrogate Decision-Making Laws
Ethicists can educate clinicians about how to identify appropriate decision-makers and the roles proxies and surrogates ought to play in patient care. Equally important is ensuring providers know where to go for help if such questions arise.
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Remote Consults Expand Reach of Ethics, But Complex Cases Remain Challenging
It is too difficult for an ethicist to mediate and facilitate if he or she is not physically present in the room.
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Most PICU Clinicians Report Moral Distress During COVID-19 Pandemic
Ethicists should join rounds on various units, routinely conduct multiprofessional team debriefing sessions within departments and units, and offer educational workshops on ethical frameworks.