Moral Injury Among Transplant Providers: Evaluating the Effects of Training in End-of-Life Counseling.

Introduction: Ethical issues are pervasive in healthcare, but few specialties rival the moral complexity of transplant medicine. Transplant providers must regularly inform patients that they are no longer eligible to receive a potentially life-saving operation and the stress of these conversations poses a high risk of moral injury. Training in end-of-life counseling (EOLC) has proven to significantly reduce provider stress and burnout.

Infertility Counseling and Misattributed Paternity: When Should Physicians Become Involved in Family Affairs?

Infertility specialists may be confronted with the ethical dilemma of whether to disclose misattributed paternity (MP). Physicians should be prepared for instances when an assumed father's evaluation reveals a condition known for lifelong infertility, for example, congenital bilateral absence of vas deferens (CBAVD). When there is doubt regarding a patient's comprehension of his diagnosis, physicians must consider whether further disclosure is warranted.

Individual Experiences and Utilization of Supportive Resources in Adolescents and Young Adults with Cancer.

Adolescents and young adults (AYAs) with cancer are often impacted by distress due to disease and treatment. Despite these concerns, prior research has found that AYAs do not utilize support resources, do not find these resources adequate, and or do not have adequate access to services. The objective of this project was to understand and identify AYA patient concerns and experiences throughout cancer treatment, what resources were utilized, how they were identified, and how supportive care resources for AYA cancer patients can be improved.

Moving It Along: A study of healthcare professionals' experience with ethics consultations.

Background: Ethics consultation is the traditional way of resolving challenging ethical questions raised about patient care in the United States. Little research has been published on the resolution process used during ethics consultations and on how this experience affects healthcare professionals who participate in them.

Objectives: The purpose of this qualitative research was to uncover the basic process that occurs in consultation services through study of the perceptions of healthcare professionals.

HCEC pearls and pitfalls: suggested do's and don't's for healthcare ethics consultants.

Members of the Clinical Ethics Consultation Affairs Standing Committee of the American Society for Bioethics and Humanities present a collection of insights and recommendations developed from their collective experience, intended for those engaged in the work of healthcare ethics consultation.

Documented consent process for implantable cardioverter-defibrillators and implications for end-of-life care in older adults.

Implantable cardioverter defibrillators (ICDs) reduce mortality in selected patients at risk for life-threatening heart arrhythmias, and their use is increasingly common. However, these devices also confer risk for delivery of unexpected painful shocks during the dying process, thus reducing the quality of palliative care at the end of life. This scenario can be avoided by ICD deactivation in appropriate circumstances but patients will remain unaware of this option if not informed about it.

Pastoral products or pastoral care? How marketplace language affects ministry in veterans hospitals.

The author describes a veterans hospital context of healthcare ministry in which marketplace terminology, adopted institutionally, also impacts the Chaplain Service. He highlights specific elements of this commercialization of pastoral care, such as computerized documentation of "spiritual products" delivered in increments of ten minute units. Noting the power of language both to describe and create realities, the author suggests likely risks accompanying benefits of healthcare chaplaincy carried out on marketplace terms.

An ethics conflict and culture: should this kidney be used?

The practice of nursing in transplant medicine is often fraught with ethical complexity. It is especially so when children are involved as potential living donors. This is no less true when the donor "child" is of consenting age, and when the intended recipient is the parent.