What Should Clinicians in Organizations Without Established MLP Programs Do When Their Patients Need Lawyers to Meet Their Health Needs?

Undocumented people in the United States face innumerable legal and structural barriers to health and health care services, including for kidney failure. Their experiences vary across states and regions due to wide variation in insurance coverage and unreliable access to health-promoting resources, including medical-legal partnerships. This commentary on a case canvasses key policy about structural and legal determinants of health for undocumented persons.

How Should MLP Clinicians and Attorneys Help Veterans Secure Disability Benefits When Health Records Documentation Is Insufficient?

This case commentary considers unique features of medical-legal partnerships (MLPs) in the Veterans Health Administration that may potentially mediate and minimize ethical tensions that may arise in MLP collaborations involving diagnosing and documenting disability.

What Are Epidemiological Foundations for Integrating Legal Services Into Health Care Settings?

Medical-legal partnerships vary widely in how they are structured and use data to inform service delivery. Epidemiological data on certain chronic conditions' prevalence, the incidence of potentially preventable morbidity, and health-harming legal factors also influence approaches to care. This article draws on a pediatric example of how data-driven medical care complements data-driven legal care. This article also considers medical and public health ethical frameworks to guide protected information sharing, promote optimal service delivery, and achieve the best possible medical-legal outcomes.

Can Medical-Legal Partnerships Do More to Advance Reproductive Justice After Dobbs?

The medical-legal partnership (MLP) and reproductive justice (RJ) movements both seek to solve complex problems, serve diverse populations with intersectional challenges, and resolve community conditions that impact people's ability to reach their highest health potential. Yet MLPs have been overlooked as a strategy to advance reproductive health and justice. MLP has distinct advantages for advancing RJ, and many MLPs might already be doing RJ work without referring to it by name. By intentionally adopting an RJ strategy and explicitly addressing the unmet social and legal needs that limit people's ability to plan their reproductive futures, MLPs can better serve their clients and contribute to the movement to combat reproductive oppression.

Ethical and Legal Perspectives on the Treatment of Hypoxic Ischemic Encephalopathy in the Newborn.

Hypoxic ischemic encephalopathy (HIE) in neonates can cause severe, life-long functional impairments or death. Treatment of these neonates can involve ethically challenging questions about if, when, and how it may be appropriate to limit life-sustaining medical therapy. Further, parents whose infants suffer severe neurologic damage may seek recourse in the form of a medical malpractice lawsuit. This study uses several hypothetical cases to highlight important ethical and legal considerations in the care of infants with HIE.

Generative artificial intelligence and the personalization of health professional education: A narrative review.

This narrative review examined the intersection of generative artificial intelligence (GAI) and the personalization of health professional education (PHE). This review aims to the elucidate the current condition of GAI technologies and their particular uses in the field of PHE. Data were extracted and analyzed from studies focusing on the demographics and professional development preferences of healthcare workers, the competencies required for personalized precision medicine, and the current and potential applications of artificial intelligence (AI) in PHE. The review also addressed the ethical implications of AI implementation in this context. Findings indicated a gender-balanced healthcare workforce with a predisposition toward continuous professional development and digital tool utilization. A need for a comprehensive educational framework was identified to include a spectrum of skills crucial for precision medicine, emphasizing the importance of patient involvement and bioethics. AI was found to enhance educational experiences and research in PHE, with an increasing trend in AI applications, particularly in surgical education since 2018. Ethical challenges associated with AI integration in PHE were highlighted, with an emphasis on the need for ethical design and diverse development teams. Core concepts in AI research were established, with a spotlight on emerging areas such as data science and learning analytics. The application of AI in PHE was recognized for its current benefits and potential for future advancements, with a call for ethical vigilance. GAI holds significant promise for personalizing PHE, with an identified need for ethical frameworks and diverse developer teams to address bias and equity in educational AI applications.

The relationship professional commitment and ethics with patient rights: a cross-sectional descriptive study.

BACKGROUND: Ethical behavior of health workers is an important part of health services. The aim of the present study was to determine the relationship between ethics and professional commitment and its relationship with the level of respect for patient rights in medical students. MATERIAL & METHODS: A cross-sectional descriptive study was conducted with the participation of nursing, midwifery and emergency medicine students of Ilam University of Medical Sciences. Sampling was done by stratified random method. The data was collected using Demographic, Professional Commitment, Professional ethics and a researcher made questioner on compliance with patient rights questionnaires. RESULTS: 300 students were participated. The results showed that the average score of professional ethics in middle school students is high (64.07 ± 8.01), the average score of professional commitment is also high (64.07 ± 8.01) and the score of respect for patient rights is also high (10.74). ± 83.46) was obtained. The professional ethics score it showed a positive and statistically significant relationship with the patient's rights compliance score. only professional commitment is related to gender, but the average of all three variables in different age groups and the type of residence (dormitory, private home, etc.) have meaningful statistical difference. CONCLUSION: The findings of the study show that the level of ethics and professional commitment and respect for patient rights among nursing, midwifery and emergency medicine students was good. It is hoped that the results of this research will provide a basis for better planning for the development of knowledge and respect for patient rights among students.

State Abortion Policy and Moral Distress Among Clinicians Providing Abortion After the Dobbs Decision.

Importance: Moral distress occurs when individuals feel powerless to do what they think is right, including when clinicians are prevented from providing health care they deem necessary. The loss of federal protections for abortion following the Dobbs v Jackson Women's Health Organization Supreme Court decision may place clinicians providing abortion at risk of experiencing moral distress, as many could face new legal and civil penalties for providing care in line with professional standards and that they perceive as necessary. Objective: To assess self-reported moral distress scores among abortion-providing clinicians following the Dobbs decision overall and by state-level abortion policy. Design, Setting, and Participants: This survey study, conducted from May to December 2023, included US abortion-providing clinicians (physicians, advanced practice clinicians, and nurses). A purposive electronic survey was disseminated nationally through professional listservs and snowball sampling. Exposure: Abortion policy in each respondent's state of practice (restrictive vs protective using classifications from the Guttmacher Institute). Main Outcomes and Measures: Using descriptive statistics and unadjusted and adjusted negative binomial regression models, the association between self-reported moral distress on the Moral Distress Thermometer (MDT), a validated psychometric tool that scores moral distress from 0 (none) to 10 (worst possible), and state abortion policy was examined. Results: Overall, 310 clinicians (271 [87.7%] women; mean [SD] age, 41.4 [9.7] years) completed 352 MDTs, with 206 responses (58.5%) from protective states and 146 (41.5%) from restrictive states. Reported moral distress scores ranged from 0 to 10 (median, 5) and were more than double for clinicians in restrictive compared with protective states (median, 8 [IQR, 6-9] vs 3 [IQR, 1-6]; P < .001). Respondents with higher moral distress scores included physicians compared with advanced practice clinicians (median, 6 [IQR, 3-8] vs 4 [IQR, 2-7]; P = .005), those practicing in free-standing abortion clinics compared with those practicing in hospitals (median, 6 [IQR, 3-8] vs 4 [IQR, 2-7]; P < .001), those no longer providing abortion care compared with those still providing abortion care (median, 8 [IQR, 4-9] vs 5 [IQR, 2-8]; P = .004), those practicing in loss states (states with the greatest decline in abortion volume since the Dobbs decision) compared with those in stable states (unadjusted incidence rate [IRR], 1.72 [95% CI, 1.55-1.92]; P < .001; adjusted IRR, 1.59 [95% CI, 1.40-1.79]; P < .001), and those practicing in surge states (states with the greatest increase in abortion volume since the Dobbs decision) compared with those in stable states (unadjusted IRR, 1.27 [95% CI, 1.11-1.46]; P < .001; adjusted IRR, 1.24 [95% CI, 1.09-1.41]; P = .001). Conclusions and Relevance: In this purposive national survey study of clinicians providing abortion, moral distress was elevated among all clinicians and more than twice as high among those practicing in states that restrict abortion compared with those in states that protect abortion. The findings suggest that structural changes addressing bans on necessary health care, such as federal protections for abortion, are needed at institutional, state, and federal policy levels to combat widespread moral distress.

Ethical consideration in programme evaluation for health professional education programmes.

Objectives: To explore the ethical considerations and measures of quality assurance during data-collection for programme evaluation in health professional education. METHODS: The qualitative case study was conducted at Bahria University of Health Sciences, Karachi, from August to November 2023, and comprised faculty members involved in programme evaluation for at least two years having done a minimum two audit cycles. System thinking philosophical framework was used during the data-collection phase. A diverse sample was selected to ensure representation from different sectors and roles within the teams. Data was collected through participant observation, semi-structured interviews and focus group discussions. Data was subjected to thematic analysis. RESULTS: There were 7 faculty members who were interviewed individually twice in addition to 4 focus group discussion. Members of quality assurance team were experts in their respective fields, but were not found to be wellversed in terms of ethical considerations that should guide data-collection. This lack of knowledge may inadvertently lead to ethical lapses in the evaluation process. Another ethical challenge seen was bias in the data-collection phase. Conclusion: Faculty members integral to programme evaluation efforts were found to lack knowledge regarding ethical considerations in data-collection, which can pose significant risks.