Medical providers involved in child abuse cases will encounter a variety of issues with legal implications, including informed consent, appropriate documentation, confidentiality, mandated reporting and potential liability. Consequently, all medical providers who may become involved in child abuse cases should have a fundamental understanding of child maltreatment laws in their jurisdiction. While informed consent is a well-established medicolegal doctrine in many countries, there are often jurisdiction-specific variations in cases of suspected child maltreatment. Complete, accurate and objective medical documentation is also imperative, as medical reports are frequently submitted in legal proceedings. Care should be taken, however, to ensure appropriate release and retention of medical records in accordance with country-specific legislation (e.g., Health Insurance Portability and Accountability Act and 21st Century Cures Act in the United States). Finally, medical providers should understand their responsibility to report to the appropriate protective services agency if there is reasonable suspicion that child maltreatment has occurred. A practitioner’s failure to adhere to statutory requirements may result in negative actions against the provider.

This chapter illustrates a challenging clinical ethics case involving a twenty-something trauma patient experiencing dysphagia who declined recommendations for artificial nutrition and wanted to be allowed to take food and fluid by mouth. Capacity assessment was complicated by disagreements over clinical facts. The Ethics consultation process was impacted by limited consultant bandwidth and lack of institutional support. Moral distress was experienced by many team members including clinical ethicists who found themselves wondering how this consult went wrong, and whether withholding food from a decisionally capable patient was in fact within the rights of the healthcare team.

Diagnosing, treating, and caring for individuals with dementia-related syndroms raises unique legal and ethical questions. Individuals with dementia may be more likely to lack decision-making capacity. Additionally, along with their families, individuals with dementia will face complicated health care related decisions – complicated by limited therapy options. This chapter identifies key legal and ethical questions that come up in the clinical and non-clinical setting relevant to dementia-related syndromes.

This chapter provides a comprehensive overview of the ethical principles and codes of conduct that every researcher in applied linguistics should follow. It emphasizes the importance of ethics in research, ensuring that all studies are conducted with integrity and respect for human rights and welfare. A central focus is placed on informed consent, particularly its role and importance when conducting research with human participants. The chapter discusses various ethical considerations related to data collection, analysis, management, and sharing, while also addressing the responsible reporting of research results. Additionally, unique ethical challenges are explored, especially those that arise when conducting research with children. After reading this chapter, you will be well-prepared to approach your work with a heightened sense of ethical responsibility, ensuring your research is both impactful and respectful of the individuals and communities being studied.

This chapter discusses the role of palliative care in the management of respiratory problems in neurological disease. To realize the right to live and to enjoy equal participation for neurological patients with respiratory symptoms may be complex and require extensive human, technical and financial resources, and, especially in low- and mid-income countries these resources may not be present. National and cultural differences in the role of palliative care are discussed, furthermore specific problems of palliative care in respiratory therapy such as correct indications, informed consent issues, therapy restriction physician-assisted suicide and euthanasia, in care settings such as critical care. The authors suggest a pathway to decision-making and introduce treatment strategies with a focus on respiratory symptoms.

In this chapter of Complex Ethics Consultations: Cases that Haunt is, the author describes the request of a middle-aged patient with COPD for terminal ventilator withdrawal. The consult occurred soon after the author began working at a Catholic hospital. The patient’s husband objected to withdrawal, despite the fact that the patient had reasonable capacity and could mouth or write. The attending physician said he would not withdraw treatment if "there was disagreement" in the family. Upon questioning, the patient reiterated her wishes and said the team should not abide by his wishes and did not want him involved in the decision if he was objecting to her request. A week later, still on the ventilator, she declined SNF placement and her distraught husband wanted transfer. Suspicions about her husband gained traction on the unit. The author offers advice and insights for new ethics consultants. She was haunted by her inexperience, her doubt whether she was assertive enough, the narrative around her husband’s suitability as a surrogate, and some of the staff’s admonition that the consultant did sufficiently advocate for the patient.

Ethical decisions must be made at every phase of a research study. Codes of ethics provide guidance on behaviors that are permissible or nonpermissible for research investigators. In contemporary science, investigators are required to have regular training on the responsible research conduct relevant to studies involving human subjects and animals. Despite this training, ethical lapses occur. This chapter explores some of the basic issues, including ethical mandates on what should be done, what must be done, and what must not be done. We consider the history of serious ethical concerns, such as the Tuskegee experiment. The chapter also reviews historical milestones such as the Belmont report, the Declaration of Helsinki, and the establishment of the Common Rule that is applied for research funded by US federal agencies. Further, the chapter explores challenges relevant to the reporting of conflicts of interests, imperfections in institutional review boards (IRBs), and ethical challenges in studies that use placebos. Among a range of research methods, randomized controlled trials tend to encounter the greatest number of ethical concerns.

Module 6 presents various ways in which cultures understand, describe, and explain illness. These conceptualizations are based in cultural ontologies and epistemologies, affecting how people communicate about illnesses and their expectations for treatment and outcomes. Indigenous and shamanic traditions are presented.

Chapter 3 explores safety and ethics in online and offline environments, particularly focused on research with adolescents. The chapter emphasises the need for a more rapid response to a very rapidly evolving field. Ethics is understood from a dynamic perspective, adapting to the individual, contextual, social and cultural contexts and needs of individuals and studies. Getting the balance right between enabling adolescent voice and safety is challenging.

The availability of data is a condition for the development of AI. This is no different in the context of healthcare-related AI applications. Healthcare data are required in the research, development, and follow-up phases of AI. In fact, data collection is also necessary to establish evidence of compliance with legislation. Several legislative instruments, such as the Medical Devices Regulation and the AI Act, enacted data collection obligations to establish (evidence of) the safety of medical therapies, devices, and procedures. Increasingly, such health-related data are collected in the real world from individual data subjects. The relevant legal instruments therefore explicitly mention they shall be without prejudice to other legal acts, including the GDPR. Following an introduction to real-world data, evidence, and electronic health records, this chapter considers the use of AI for healthcare from the perspective of healthcare data. It discusses the role of data custodians, especially when confronted with a request to share healthcare data, as well as the impact of concepts such as data ownership, patient autonomy, informed consent, and privacy and data protection-enhancing techniques.