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  1.  5
    How Should We Allocate Divisible Resources? An Overlooked Question.Mara Buchbinder & Noah Berens - 2024 - Journal of Clinical Ethics 35 (1):59-64.
    The ethical allocation of scarce medical resources has received significant attention, yet a key question remains unaddressed: how should scarce, divisible resources be allocated? We present a case from the COVID-19 pandemic in which scarce resources were divided among patients rather than allocated to some patients over others. We assess how widely accepted allocation principles could be applied to this case, and we show how these principles provide insufficient guidance. We then propose alternatives that may help guide decision-making in such (...)
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  2.  41
    When Can Physicians Fire Patients with Opioid Use Disorder for Nonmedical Use of Prescription Medications?Levi Durham - 2024 - Journal of Clinical Ethics 35 (1):65-69.
    The opioid crisis has greatly increased the number of patients who are illegally injecting drugs while hospitalized for other conditions. Physicians face a difficult decision in these circumstances: when is it appropriate to involuntarily discharge or “fire” a patient with opioid use disorder for their continued nonmedical use of opioids? This commentary analyzes physicians’ responsibilities to their patients and argues that physicians should fire non-adherent patients only when every other option has been exhausted and the expected benefits of firing the (...)
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  3.  20
    Dual Advocates in Deceased Organ Donation: The Potential for Moral Distress in Organ Procurement Organization Staff.Anna D. Goff & Hannah C. Boylan - 2024 - Journal of Clinical Ethics 35 (1):70-75.
    Organ procurement organization (OPO) staff play an essential role in the facilitation of organ donation as they guide family members and loved ones of dying patients through the donation process. Throughout the donation process, OPO staff must assume the role of a dual advocate, considering both the interests of the donor (which often include the wishes of the donor’s family) and the interests of potential recipient(s). The benefits of this role are well established; however, minimal literature exists on the ways (...)
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  4.  26
    Home Birth in the United States: An Evidence-Based Ethical Analysis.Marielle S. Gross, Vivian Altiery De Jesus & Paige M. Anderson - 2024 - Journal of Clinical Ethics 35 (1):37-53.
    The assumption in current U.S. mainstream medicine is that birthing requires hospitalization. In fact, while the American College of Obstetricians and Gynecologists supports the right of every birthing person to make a medically informed decision about their delivery, they do not recommend home birth owing to data indicating greater neonatal morbidity and mortality. In this article, we examine the evidence surrounding home birth in the United States and its current limitations, as well as the ethical considerations around birth setting.
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  5.  2
    U.S. Healthcare Provider Views and Practices Regarding Planned Birth Setting.Marielle S. Gross, Ha Vi Nguyen, Jessica L. Bienstock & Natalie R. Shovlin-Bankole - 2024 - Journal of Clinical Ethics 35 (1):23-36.
    Background: Little is known about U.S. healthcare provider views and practices regarding evidence, counseling, and shared decision-making about in-hospital versus out-of-hospital birth settings. Methods: We conducted 19 in-depth, semistructured, qualitative interviews of eight obstetricians, eight midwives, and three pediatricians from across the United States. Interviews explored healthcare providers’ interpretation of the current evidence and their personal and professional experiences with childbirth within the existing medical, ethical, and legal context in the United States. Results: Themes emerged concerning risks and benefits, decision-making, (...)
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  6.  15
    Shifting from Equality toward Equity: Addressing Disparities in Research Participation for Clinical Cancer Research.Andrew Hantel, Gregory A. Abel, Jeffrey M. Peppercorn, Jonathan M. Marron & Elizabeth Warner - 2024 - Journal of Clinical Ethics 35 (1):8-22.
    There is societal consensus that cancer clinical trial participation is unjust because some sociodemographic groups have been systematically underrepresented. Despite this, neither a definition nor an ethical explication for the justice norm of equity has been clearly articulated in this setting, leading to confusion over its application and goals. Herein we define equity as acknowledging sociodemographic circumstances and apportioning resource and opportunity allocation to eliminate disparities in outcomes, and we explore the issues and tensions this norm generates through practical examples. (...)
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  7.  1
    New Ways to Help Patients Worst Off.Edmund G. Howe - 2024 - Journal of Clinical Ethics 35 (1):1-7.
    This introduction to The Journal of Clinical Ethics highlights and expands four articles within this issue that propose somewhat new and radical innovations to help and further the interests of patients and families worst off. One article urges us to enable historically marginalized groups to participate more than they have in research; a second urges us to allocate limited resources that can be divided, such as vaccines and even ventilators, in a different way; a third urges us to help families (...)
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  8.  11
    Duty to Family: Ethical Considerations in the Resuscitation Bay.Ashley Pavlic, Arthur R. Derse, Nancy Jacobson, Christopher Calciano & Colin Liphart - 2024 - Journal of Clinical Ethics 35 (1):54-58.
    To examine the ethical duty to patients and families in the setting of the resuscitation bay, we address a case with a focus on providing optimal care and communication to family members. We present a case of nonsurvivable traumatic injury in a minor, focusing on how allowing family more time at the bedside impacts the quality of death and what duty exists to maintain an emotionally optimal environment for family grieving and acceptance. Our analysis proposes tenets for patient and family-centric (...)
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