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What type of influence should physicians, nurses and patients have on tough choice healthcare decisions? Clinicians want to offer their experience and their competence, so should they be neutral and simply support patient decisions? What type of influence would be helpful and what type would be inappropriate, coercive, or biased? In this episode, o…
 
Drug shortages in health care occur for many reasons and have negative impacts. According to the US Food and Drug Administration, “a high percentage of drug shortages have been, and continue to be, sterile injectables, including chemotherapy, anesthesia and other acute drugs”. And, even though drug shortages have declined in recent years, a signifi…
 
In March 2020, the coronavirus pandemic created a devastating impact within and outside the United States. COVID-19 made us painfully aware of systemic racism in healthcare with the allocation of scarce resources for vulnerable populations. In May 2020, the murder of George Floyd by a police officer brought the continued injustice of systemic racis…
 
If primary health care professionals are to serve and accompany the transgender community well, what would that look like? What would need our attention? What approaches have proved helpful and supportive? What would accompaniment require from health care professionals? Our guests today are either health professionals who are transgender or who hav…
 
Offering a composite picture of someone with a drug addiction is not easy. It is not specific to gender, age, income, education, ethnicity, or geography. In this second episode on addiction and medically supervised injection rooms, we go to Melbourne Australia and speak to health care leaders there, on their experience with these programs. Again, t…
 
Harm reduction programs like needle exchange programs or medically supervised injection sites aim to a) respond to the addiction health issues of those who are dependent on injection drugs, and b) respond to the broader public health impact of addiction on a community such as a high amount of drug overdose or the transmission of infectious disease …
 
Today, tough choice healthcare ethics dilemmas are discussed by patients, their loved ones and health care professionals. These discussions are about the care and treatment plan of the patient based on their values. Most often these discussions and decisions have been held in person. As healthcare moves to virtual care, especially in our current CO…
 
Street Medicine is local and international. In this second episode on Street Medicine we hear about health care leaders in Portland, Oregon responding to the needs in their community. The challenge? Nationally, Oregon has the fourth highest rate of homelessness and the second highest rate of families without shelter. In recent years Portland’s chro…
 
A 2019 White House Report tells us that half a million people are homeless each night in the UnitedStates.In 1992, Dr. Jim Withers began doing street rounds in Pittsburgh, Pennsylvania, bringing medical care to the homeless. Since that time the Street Medicine Institute he founded has grown to become international organization. In 2015, CNN named D…
 
COVID19 has caused all of us to prepare and it has also demanded something from us. We hear many stories of the technical and resource preparation. In this episode we speak with three physicians from California and Washington state about their preparation and what it has demanded from them. We hear people in frontier territory wanting to offer thei…
 
On March 11, the World Health Organization (WHO) declared COVID-19 a pandemic, pointing to the over 118,000 cases of the coronavirus illness in over 110 countries and territories around the world and the sustained risk of further global spread. To discuss some of the ethical issues regarding COVID-19 we are joined by Dr. Ken Iserson and Becket Grem…
 
We hear many stories these days about immigration. Certainly, healthcare workers see undocumented individuals in Emergency Rooms or clinics. What is that experience like of being undocumented and needing healthcare? What would be helpful for clinicians to know? Does healthcare ethics have something to say on this topic? Today we hear from two healt…
 
As we look back on 2019 and forward to 2020, our guests are editors of key healthcare ethics journals with an international readership: Gregory E. Kaebnick, Editor, The Hastings Center Report Leslie LeBlanc, Managing Editor, Journal of Clinical Ethics Nate Hibner, Primary Editor, Health Care Ethics USA and Director of Ethics at the Catholic Health …
 
Health disparities and health outcomes for African Americans, is egregious… A 2019 report identified that African American Adults, compared to non-Hispanic white adults, are: 44% More likely to die from stroke 20% more likely to have asthma 40% more likely to die from breast cancer 25% more likely to die from heart disease 52% more likely to die fr…
 
New research findings regarding HIV status will impact how we understand and practice disclosure of HIV status of patients... specifically whether or not to disclose a sick patients’ HIV serostatus to their family or partner. The new research demonstrates that when an HIV-positive person sticks to their treatment, their HIV is undetectable and untr…
 
Buildings in TriBeCa, New York City.Urban Bioethics may be a new term for you. It is a field and focus in bioethics that points a critical lens on the extreme inequalities of health and access to medical, legal, and other resources that leave many urban dwellers and communities distinctly disadvantaged, disenfranchised, and vulnerable. What is this…
 
Imagine you are a patient that is seriously ill and the standard clinical treatment is not working for you. You may want to try experimental drug products, still being investigated and not yet approved by the US Food and Drug Administration (the FDA)…what are your options? There are currently a couple of pathways: First, you could enroll as a parti…
 
Brain death is a fundamental ethical topic that is complex and often fraught with emotion. As ethics committees are faced with considerations involving brain death, these cases are often those that stick with professionals the most. Our lead contributor in this episode Becket Gremmels, System Director of Ethics at CHRISTUS Health in Irving TX is in…
 
Why would the question of whether to provide food and water to a patient come up at all? One might assume it is always helpful and never harmful to offer nutrition and hydration to patients. Is that accurate? When might it be appropriate or not appropriate? Our lead contributor in this episode is Alan Sanders, Vice President of Ethics Integration a…
 
Those who work on responding to the ethical issues and decisions that arise in healthcare realize that we are invited into the most complex stories that patients, families , healthcare professionals and our communities have to offer. They not only involve value-laden clinical decisions about patient treatments, but community decisions about public …
 
In healthcare, we are able to capture ever increasing levels and types of data. The potential is there for more accurate diagnosis and more relevant which would better inform healthcare decisions and potentially avoid medical error or unnecessary treatments. Artificial intelligence technologies are increasingly accurate in text, in sound or in imag…
 
Informed consent is one of the foundational ethical principles in health care that supports patient autonomy, or stated differently, the patients right to self-determination. More and more the standard for what clinicians should inform patients about the risks benefits and alternatives of treatment are no longer determined by what a responsible bod…
 
Consider someone leaving a hospital, after their care is completed at that location, to return to their home and local community. As discharge plans are made to continue their care, their healing, their rehabilitation, are there ethical challenges that arise? Can there be biases that shape that plan because of their ability, disability, lack of fam…
 
As we look back on 2018 and forward to 2019, our guests are editors of key healthcare ethics journals with an international readership: Gregory E. Kaebnick, Editor, The Hastings Center Report – The Hastings Center Leslie LeBlanc, Managing Editor, Journal of Clinical Ethics Fr. Charles Bouchard, Editor, Health Care Ethics USA – Catholic Health Assoc…
 
Imagine a patient who suffers from an underlying psychiatric disability and comes to a hospital with a critical illness after prolonged non-adherence to a medical treatment plan. Because of their inability to follow a treatment plan, the patient now faces an end-of-life situation, even though the condition would otherwise not be considered terminal…
 
In the wake of past and more recent mass shootings, mental illness has been pointed to in some public statements as the root cause of mass shootings: Statements such as…1) “We don’t need a gun database, we need a mental health database in the United States”, or…2) “People don’t kill people, the mentally ill do”. With such statements, mental illness…
 
The big picture is that 115,000 men, women and children await organ transplants in the United States. Even the largest football stadium in the US could not fit the number of patients on the national transplant waiting list. In 2016, 33,600 transplants brought new life to patients and their families. Since 1988, 683,000 transplants have taken place …
 
As patients, surrogate decision makers, and clinicians discuss goals of care, questions arise regarding what interventions will physiologically work and what interventions will honor the patient’s values. Do Not Resuscitate Orders are one of the interventions frequently discussed. Our lead contributor on this episode, Mark Repenshek, Executive Dire…
 
Have you ever experienced an event, a situation or a decision where you felt that your professional integrity had been compromised? It may have occurred because of something you did, something someone else did or simply a number of events that lined up in a way that made you feel that you were between a rock and hard place. In that moment you proba…
 
The pace of developments in genetic editing over the past two years seems fast and accelerating. What are those developments, the tough choice decisions and accompanying infrastructure that are needed to support researchers, clinicians, and ethics committee members? It may seem trite but is the key to success here better listening, inclusion of voi…
 
On EthicsLab we often look at specific clinical ethical issues, tough choice dilemmas that patient and clinicians are involved in. In this episode we take a step back and look at the bigger picture…an ethic of care. How should someone be treated? Why are we asking this question today? What are some of the stories that makes this apparent? What are …
 
Since the Human Genome Project was declared complete in April of 2003, there has been great anticipation of medical treatments tailored to the individual genetic makeup of patients. For you, for patients, for family members…where have most of the advances been made since that time and what ethical questions are arising as this work continues to evo…
 
Health care ethics committees help patients and clinicians with tough choice decisions. Within this work of clinical ethics consultation, what are practical tools being used to improve their competence and impact? In this episode, our guests present such practical tools that help health care ethics committee members become more competent, become mo…
 
One of the challenging areas in clinical practice today is wanting to honor patient wishes but not being clear on the competency or capacity level a patient with dementia or behavioral health issues. In this episode we explore different challenging situations that ask: a) What is the best assessment of capacity? b) What level of risk should be supp…
 
Our guests are editors of key healthcare ethics journals with an international readership: Fr. Charles Bouchard, Editor, Health Care Ethics USA - Catholic Health Association of the United States Gregory E. Kaebnick, Editor, The Hastings Center Report - The Hastings Center Leslie LeBlanc, Managing Editor, Journal of Clinical EthicsWhat are the issue…
 
Health care professionals, patients and family members could all agree that patient wishes about their care are important and need to be respected. Why then, nationally, do only 30 percent of adults have an advance directive that documents those wishes? Given that statistic, how could the town of La Crosse, Wisconsin, achieve the surprising goal th…
 
Are there better ways to build and support a culture of clinical ethics in healthcare? What might that look like? What has worked and how could the ideas and tools offered be implemented? In the late 1990’s the idea was proposed, why not marry the work being done in health care ethics with quality improvement methodology. Would this type of “Thinki…
 
Deciding for another is difficult. One of the most challenging ethical issues faced in clinical practice today is deciding for unrepresented patients – patients who have no advance directive or no family and friends who can make decisions on behalf of the patient (surrogate decision makers) when the patient cannot speak for themselves. The moral di…
 
Tune in to this latest episode of the EthicsLab podcast. In this episode we talk with international leaders in ethics about the future of healthcare ethics. In this episode we talk with international ethics leaders about the future of health care ethics. We traded stories of events that convinced us that we need to change, that what we had done in …
 
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