AJOB empirical bioethics
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AJOB empirical bioethics · Jul 2020
"We're Not Ready, But I Don't Think You're Ever Ready." Clinician Perspectives on Implementation of Crisis Standards of Care.
Background: The COVID-19 pandemic has highlighted health care systems' vulnerabilities. Hospitals face increasing risk of periods of scarcity of life-sustaining resources such as ventilators for mechanical respiratory support, as has been the case in Italy as of March, 2020. The National Academy of Medicine has provided guidance on crisis standards of care, which call for the reallocation of scarce medical resources to those who will benefit most during extreme situations. ⋯ Despite this, many participants acknowledged the need for such a protocol to standardize care and minimize bias as well as to mitigate potential consequences for individual clinicians. Participants identified the question of considering patient quality of life in triage decisions as an important and unresolved ethical issue in disaster triage. Conclusion: Clinicians' discomfort with shifting roles and obligations could pose implementation barriers for crisis standards of care.
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AJOB empirical bioethics · Apr 2020
First Do No Harm: Ethical Concerns of Health Researchers That Discourage the Sharing of Results With Research Participants.
Background: Health researchers and health research participants support the sharing of research results; however, results are typically only shared through peer-reviewed publications. Few studies have investigated researchers' ethical concerns related to sharing results with research participants. Methods: An explanatory approach was used to explore the ethical concerns researchers may have with returning aggregate results to research participants. ⋯ Three broad ethical concerns emerged, each with underlying subthemes: 1) distress, 2) understanding, and 3) privacy. Conclusions: This is the first study to broadly explore researchers' ethical concerns with sharing aggregate research results with participants and reveals that researchers' ethical concerns are closely tied to the ethical obligation to do no harm. In order to increase results sharing, steps must be taken to help researchers understand how to minimize potential harm when sharing results.
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AJOB empirical bioethics · Apr 2020
Informed Consent in Two Alzheimer's Disease Research Centers: Insights From Research Coordinators.
Background: Informed consent (IC) is critical to performing ethical research. Unfortunately, the IC process and supporting IC forms are frequently burdensome and do not necessarily meet the informational needs of participants. The intersecting legal and ethical challenges of obtaining IC from individuals with memory or cognitive deficits further exacerbate existing IC shortcomings. ⋯ Adaptations reported include altering the cadence and vocabulary they employ, using supplemental materials, varying the order of IC topics, and limiting the depth of information presented. Conclusion: A qualitative analysis of interviews with study coordinators reveals opportunities to improve how we obtain IC in AD research. These insights will be used to create an electronic informed consent (eConsent) designed to boost engagement, enhance trust, and improve understanding by supporting participants' direct agency in the IC process.
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AJOB empirical bioethics · Oct 2019
Breaking a Vital Trust: Posting Photos of Patients on Facebook Among a Sample of Peruvian Medical Students.
Background: The doctor-patient relationship may be affected by the indiscriminate use of social media platforms. The aim of this study was to evaluate the content of the photos posted on medical students' Facebook accounts to determine whether they have posted private patient information and compare this to their self-reported behavior of posting such photos. Methods: We performed a cross-sectional study of medical students from a Peruvian private university. ⋯ Having uploaded more than 250 photos (OR:2.90; CI95%:1.14-7.39) and posting photos tagged with the location of a hospital (OR:4.02; CI95%:1.36-11.9) were associated with having posted photos containing private patient information. Conclusion: One out of three of medical students posted patients' private information on their personal Facebook profiles. Development, dissemination, and implementation of guidelines related to ethics in social media platforms are needed.
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AJOB empirical bioethics · Jan 2019
Framing the diagnosis and treatment of absolute uterine factor infertility: Insights from in-depth interviews with uterus transplant trial participants.
Despite procedural innovations and increasing numbers of uterus transplant attempts worldwide, the perspectives of uterus transplant (UTx) trial participants are lacking. ⋯ The ways in which women with AUFI conceptualize this condition in their lives and choices around UTx and participating in a study of the procedure are multifaceted and textured. These perspectives are critical to understanding its ethical, legal, and social implications.