Clinical Ethics Consultation During the First COVID-19 Pandemic Surge at an Academic Medical Center: A Mixed Methods Analysis.

While a significant literature has appeared discussing theoretical ethical concerns regarding COVID-19, particularly regarding resource prioritization, as well as a number of personal reflections on providing patient care during the early stages of the pandemic, systematic analysis of the actual ethical issues involving patient care during this time is limited. This single-center retrospective cohort mixed methods study of ethics consultations during the first surge of the COVID 19 pandemic in Massachusetts between March 15, 2020 through June 15, 2020 aim to fill this gap. Results indicate that there was no significant difference in the median number of monthly consultation cases during the first COVID-19 surge compared to the same period the year prior and that the characteristics of the ethics consults during the COVID-19 surge and same period the year prior were also similar.

How Should Clinicians Help Homeless Trauma Survivors Make Irreversible Surgical Care Decisions?

Important but frequently overlooked childhood trauma outcomes can manifest later in patients' lives and include neurophysiological influences on language perception and expression, memory, attention, abstract reasoning, emotional regulation, and executive functioning. Therefore, when interacting with patients experiencing homelessness, mental illnesses, and substance use disorders, clinicians should adopt a trauma-informed approach to generating deeper understandings of patients' neurobiological makeup and psychosocial histories, especially when discussing interventions and during informed consent.