Developing a Postpandemic Model for Hybrid Clinical Ethics Rotations in Postgraduate Medical Education.

Bioethics education in residency helps trainees achieve many of the Accreditation Council for Graduate Medical Education milestones and gives them resources to respond to bioethical dilemmas. For this purpose, The Providence Center for Health Care Ethics has offered a robust clinical ethics rotation since 2000. The importance of bioethics for residents was highlighted as the COVID-19 pandemic raised significant bioethical concerns and moral distress for residents.

Differences in US Regional Healthcare Allocation Guidelines During the COVID-19 Pandemic.

Background: Hospitals faced unprecedented scarcity of resources without parallel in modern times during the COVID-19 pandemic. This scarcity led healthcare systems and states to develop or modify scarce resource allocation guidelines that could be implemented during "crisis standards of care" (CSC). CSC describes a significant change in healthcare operations and the level of care provided during a public health emergency.

Responding to Cultural Limitations on Patient Autonomy: A Clinical Ethics Case Study.

This paper is a clinical ethics case study which sheds light on several important dilemmas which arise in providing care to patients from cultures with non-individualistic conceptions of autonomy. Medical professionals face a difficult challenge in determining how to respond when families of patients ask that patients not be informed of bad medical news. These requests are often made for cultural reasons, by families seeking to protect patients.

Extremely premature birth, informed written consent, and the Greek ideal of sophrosyne.

Most extremely premature infants die in the intensive care unit or suffer significant neurologic impairment. Many therapies result in unhealthy consequences, and the emotional and financial turmoil for families warrant reappraisal of our motives. Shared decision-making and informed consent in preference-sensitive conditions imply the family: (a) understands the medical problem, (b) grasps the risks and benefits of each therapy, (c) has the opportunity to ask questions and reflect upon options, (d) knows their values and preferences are understood, and (e) accepts or declines therapies without judgment or penalty.

Erasmus Mundus Master of Bioethics: a case for an effective model for international bioethics education.

Designing bioethics curriculum for international postgraduate students is a challenging task. There are at least two main questions, which have to be resolved in advance: (1) what is a purpose of a particular teaching program and (2) how to respectfully arrange a classroom for students coming from different cultural and professional backgrounds. In our paper we analyze the case of the Erasmus Mundus Master of Bioethics program and provide recommendations for international bioethics education.

Family-driven quality improvement in inpatient end-of-life care.

To enhance end-of-life care in a community hospital system, an interdisciplinary team designed and implemented a mail survey to obtain feedback from families of inpatients who died. The 855 completed surveys (a 31% response rate) demonstrate that bereaved families are willing to give feedback on care received from nurses and physicians and attention paid to the personal needs of patients and families. The team used families' feedback to shape quality improvement initiatives and focused on questions with comparatively lower scores: physician communication, physician compassion, and family understanding of what to expect as their loved one approached the end of life.