Duty to Family: Ethical Considerations in the Resuscitation Bay
We present a case of nonsurvivable traumatic injury in a minor, focusing on how allowing family more time at the bedside impacts the quality of death and what duty exists to maintain an emotionally optimal environment for family grieving and acceptance. Our analysis proposes tenets for patient and family-centric care that, in alignment with trauma-informed care principles, optimize the long-term well-being of the family, namely valuing family desires and sensitivity to location.PMID:38373333 | DOI:10.1086/728141 (Source: Journal of Clinical Ethics)
Source: Journal of Clinical Ethics - February 19, 2024 Category: Medical Ethics Authors: Colin Liphart Christopher Calciano Nancy Jacobson Arthur R Derse Ashley Pavlic Source Type: research
Shifting from Equality toward Equity: Addressing Disparities in Research Participation for Clinical Cancer Research
J Clin Ethics. 2024 Spring;35(1):8-22. doi: 10.1086/728144.ABSTRACTAbstractThere is societal consensus that cancer clinical trial participation is unjust because some sociodemographic groups have been systematically underrepresented. Despite this, neither a definition nor an ethical explication for the justice norm of equity has been clearly articulated in this setting, leading to confusion over its application and goals. Herein we define equity as acknowledging sociodemographic circumstances and apportioning resource and opportunity allocation to eliminate disparities in outcomes, and we explore the issues and tensions th...
Source: Journal of Clinical Ethics - February 19, 2024 Category: Medical Ethics Authors: Elizabeth Warner Jonathan M Marron Jeffrey M Peppercorn Gregory A Abel Andrew Hantel Source Type: research
How Should We Allocate Divisible Resources? An Overlooked Question
We present a case from the COVID-19 pandemic in which scarce resources were divided among patients rather than allocated to some patients over others. We assess how widely accepted allocation principles could be applied to this case, and we show how these principles provide insufficient guidance. We then propose alternatives that may help guide decision-making in such cases, and we evaluate the possibility of treating patients equally by dividing resources equally. Resource scarcity is not limited to pandemic situations, and many healthcare resources are divisible. This question-how to allocate these divisible resources-de...
Source: Journal of Clinical Ethics - February 19, 2024 Category: Medical Ethics Authors: Noah Berens Mara Buchbinder Source Type: research
When Can Physicians Fire Patients with Opioid Use Disorder for Nonmedical Use of Prescription Medications?
J Clin Ethics. 2024 Spring;35(1):65-69. doi: 10.1086/728146.ABSTRACTAbstractThe opioid crisis has greatly increased the number of patients who are illegally injecting drugs while hospitalized for other conditions. Physicians face a difficult decision in these circumstances: when is it appropriate to involuntarily discharge or "fire" a patient with opioid use disorder for their continued nonmedical use of opioids? This commentary on a case analyzes physicians' responsibilities to their patients and argues that physicians should fire nonadherent patients only when every other option has been exhausted and the expected benefi...
Source: Journal of Clinical Ethics - February 19, 2024 Category: Medical Ethics Authors: Levi Durham Source Type: research
Dual Advocates in Deceased Organ Donation: The Potential for Moral Distress in Organ Procurement Organization Staff
J Clin Ethics. 2024 Spring;35(1):70-75. doi: 10.1086/728145.ABSTRACTAbstractOrgan procurement organization (OPO) staff play an essential role in the facilitation of organ donation as they guide family members and loved ones of dying patients through the donation process. Throughout the donation process, OPO staff must assume the role of a dual advocate, considering both the interests of the donor (which often include the wishes of the donor's family) and the interests of potential recipient(s). The benefits of this role are well established; however, minimal literature exists on the ways this role can cause moral distress ...
Source: Journal of Clinical Ethics - February 19, 2024 Category: Medical Ethics Authors: Hannah C Boylan Anna D Goff Source Type: research
