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Index of material from the Ethics Center
The National Center for Ethics in Health Care (NCEHC) produces a variety of material addressing different aspects of health care ethics. The material is released in the form of national policy, National Ethics Committee Reports, National Ethics Teleconferences, periodic center publications, and papers addressing specific issues such as pandemic influenza preparedness.
This material can be accessed in a variety of ways. On this page you can find NCEHC-produced material sorted by subject or keyword. You can also find the same material sorted by health care ethics domain and topic on the Ethics Resources page. If you want to explore our material by type (policies, National Ethics Committee Reports, National Ethics Teleconferences, periodic center publications, etc.) use the blue navigation bar located to the left.
Use the links below to find resources created by the National Center for Ethics in Health Care that explore ethical issues.
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Note: The information contained in NCEHC publications is current as of the date of publication. However, health care ethics is a dynamic field in which best practices and thinking are constantly evolving. Therefore, some information in our publications may become outdated or may be superseded. We note these instances when they occur, and we encourage users to consult additional authorities on these topics, including current VA policy and regulation.
IntegratedEthics materials
Follow this link to access IntegratedEthics materials organized by type of material.
7332 Issues
Source Patient HIV Testing in Patients who Lack Decision-Making Capacity (NET Summary October 2002) *SUPERSEDED OR OUTDATED
Consent for HIV Testing: Must the Patient's Signature on VA Form 10-0121 Be Witnessed? (Ethics Rx December 2004) *SUPERSEDED OR OUTDATED
Informed Consent for HIV Testing: Ethical Issues (NET Summary June 2004) *SUPERSEDED OR OUTDATED
May Clinicians Disclose Health Information Protected Under 38 U.S.C. §7332 to Surrogates? (Ethics Rx February 2006) *SUPERSEDED OR OUTDATED
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Advance care planning
General
Advance Care Planning and Management of Advance Directives (NET Summary March 2007) *SUPERSEDED OR OUTDATED
How Can Patients Communicate Their Wishes About Life-Sustaining Treatment? (Ethics Rx March 2005)
Strategies to Make Advance Care Planning More Effective: Best Practices (NET Summary March 2003) *SUPERSEDED OR OUTDATED
Legal Briefs: Advance Directives: VA vs. non-VA forms (news@vhaethics Spring 2001) *SUPERSEDED OR OUTDATED
Best Practices: Advance Care Planning (news@vhaethics Spring 2001)
Mental health
Documenting Veterans' Mental Health Treatment Preferences in Advance Directives (Ethics Rx June 2009)
Advance Directives for Mental Health: An Ethical Analysis of State Laws & Implications for VHA Policy (NEC Report February 2008)
National Ethics Committee Report: Advance Directives for Mental Health: An Ethical Analysis of State Laws & Implications for VHA Policy (NET Summary March 26, 2008) *SUPERSEDED OR OUTDATED
Must All Patients Be Asked About Mental Health Advance Directives? (Ethics Rx February 2005)
Ethical Issues in Advance Directives for Behavioral Health Care (NET Summary May 2003)
Policies
VHA Handbook 1004.02 Advance Care Planning and Management of Advance Directives
VA Form 10-0137 VA Advance Directive - Durable Power of Attorney for Health Care and Living Will
VA 10-0137A Your Rights Regarding Advance Directives
VA 10-0137B What You Should Know About Advance Directives
Worksheets
Advance care planning worksheets updated August 2011: Mental Health Treatment Preferences and Who to Contact
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Adverse events
Critical Thinking About Institutional Disclosure of Adverse Events to Patients (National Call August 2012)
Clinical and Institutional Disclosure of Adverse Events to Patients (National Call May 2012)
Audio file of Clinical and Institutional Disclosure of Adverse Events to Patients (National Call May 2012)
VHA Handbook 1004.08 Disclosure of Adverse Events to Patients
Adverse Events and the Management of DNR Orders: Ethical Considerations (NET Summary September 2006) *SUPERSEDED OR OUTDATED
Disclosing Adverse Events to Patients (NEC Report March 2003)
National Ethics Committee Report: Disclosing Adverse Events to Patients (NET Summary April 2003)
Notification of Patients Potentially Exposed to Mad Cow Disease Through Prior Blood Transfusion: Testing the Limits of Full Disclosure (NET Summary April 2001)
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Allocation of resources
Macroallocation
Meeting the Challenge of Pandemic Influenza: Ethical Guidance for Leaders and Health Care Professionals in the Veterans Health Administration (VHA) (July 2010)
VA FACT SHEET FOR HEALTH CARE STAFF: Meeting the Ethical Challenges of a Severe Pandemic Influenza
Ethical Considerations for Resource Allocation in Health Care (NET Summary May 27, 2009 and June 30, 2009)
IntegratedEthics Online Learning Module, Ethical Practices in Resource Allocation
Influenza Pandemic Preparedness Planning: Ethics Concerns (NET Summary June 2006)
STAFF DISCUSSION FORUM MATERIALS: Ethical Issues in Pandemic Influenza Preparedness and Response – Material to Guide Staff Discussions
Tough Decisions: Preparing VA for the Ethical Challenges of Pandemic Influenza
Policy Perspectives: The Administrator's Dilemma (news@vhaethics Fall 2003)
Foglia MB, Pearlman RA, Bottrell MM, Altemose JA, Fox E. Priority Setting and the Ethics of Resource Allocation within VA Healthcare Facilities: Results of a Survey. Organizational Ethics. 2008 Fall-Winter;4(2):83-96. (based on research conducted as part of the IESS).
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Business integrity
The Relationship Between Ethics and Compliance and Business Integrity (NET Summary July 2001)
Legal Briefs: Integrating Documentation, Compliance, and Ethics (news@vhaethics Spring 2002)
Integrating Ethics with Compliance. Council of Ethical Organizations. Compliance Case Study Library 1999:60-76. Oak J. Return to index
Capacity
Ten Myths about Decision-Making Capacity (NEC Report September 2002)
Ten Myths About Decision-Making Capacity (NET Summary November 2002)
Source Patient HIV Testing in Patients who Lack Decision-Making Capacity (NET Summary October 2002) *SUPERSEDED OR OUTDATED
Common Pitfalls in Determining Decision-Making Capacity-Live from the National Ethics Committee Meeting (NET Summary March 2001)
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Cardiac pacemakers/defibrillators
Ethical Considerations of Cardiac Pacemakers and Implantable Defibrillators for End-of-Life Care (NET Summary April 2006)
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Cardiopulmonary resuscitation
VHA Handbook 1004.3 Do Not Resuscitate (DNR) Protocols within the Department of Veterans Affairs
VHA Handbook 1004.04 State-Authorized Portable Orders
State-Authorized Portable Orders: Out of Hospital DNR Orders and Orders for Life-Sustaining Treatment (NET Summary July 2007)
Adverse Events and the Management of DNR Orders: Ethical Considerations (NET Summary September 2006) *SUPERSEDED OR OUTDATED
May Do-Not-Resuscitate (DNR) Orders Be Suspended for Surgery? (Ethics Rx January 2005)
What Does DNR Really Mean? (NET Summary June 2005) DNR FAQs
Clarification of VA Do Not Resuscitate (DNR) Policy—Orders Written by Residents (Ethics Rx May 2003)
Ethics Rounds: Wristbands for DNR? (news@vhaethics Fall 2000)
Policy Perspectives: Should Residents be Allowed to Enter DNR Orders? (news@vhaethics Summer/Fall 2002)
Do Not Resuscitate Policy Revision: Controversial Topics (NET Summary March 2002)
Family Presence During Resuscitation (NET Summary August 2001)
DNR Orders and Medical Futility (NEC Report December 2000)
DNR Orders and the Electronic Medical Record (NET Summary December 2000)
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Chronic pain
Ethical Considerations in Opioid Therapy for Chronic Pain (IN fOCUS April 2005)
Ethical Considerations in Opioid Therapy for Chronic Pain Management (NET Summary November 2005)
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Confidentiality
The Ethical Challenges of Coordinating Mental Health Care Between VHA and DoD (NET Summary March 2006)
May Clinicians Disclose Health Information Protected Under 38 U.S.C. §7332 to Surrogates? (Ethics Rx February 2006) *SUPERSEDED OR OUTDATED
Shared Medical Appointments: Ethical Concerns (NET Summary October 2005)
The Ethical Duty to Protect Third Parties from Dangerous Patients (NET Summary April 2005)
Disclosing Patients' Protected Health Information to Surrogates (NEC Report February 2005)
Disclosing Patients' Protected Health Information (NET Summary February 2005) *SUPERSEDED OR OUTDATED
Consent for HIV Testing: Must the Patient's Signature on VA Form 10-0121 Be Witnessed? (Ethics Rx December 2004) *SUPERSEDED OR OUTDATED
Informed Consent for HIV Testing: Ethical Issues (NET Summary June 2004) *SUPERSEDED OR OUTDATED
Provider Reporting of Impaired or Potentially Impaired Drivers (NET Summary February 2002)
Access to VA Databases for Research Purposes (NET Summary February 2001)
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Conflicts of interest
VHA Handbook 1004.07 Financial Relationships Between VHA Health Care Professionals and Industry
VHA Handbook 1004.07: Financial Relationships Between VHA Health Care Professionals and the Pharmaceutical Industry (NET Summary November 24, 2009)
Compensation to Health Care Professionals from the Pharmaceutical Industry (NEC Report February 2006)
National Ethics Committee Report: Compensation to Health Care Professionals from the Pharmaceutical Industry (NET Summary February 2006)
Ethical Boundaries in the Patient-Clinician Relationship (NEC Report July 2003)
National Ethics Committee Report: Ethical Boundaries in the Patient Clinician Relationship (NET Summary September 2003)
Gifts to Health Care Professionals from the Pharmaceutical Industry (NEC Report October 2003)
National Ethics Committee Report: Gifts to Health Care Professionals from the Pharmaceutical Industry (NET Summary January 2004)
Ethics Rounds: Sale of House to a Patient? (news@vhaethics Winter 2001)
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Consent
General
When Must Clinicians Obtain a Separate Consent for Use of Blood Products in the Post-Operative Period? (Ethics Rx August 2006)
Practicing Medical Procedures on the Newly Dead (NET Summary November 2003)
Ethics Rounds: Substituted Judgment or Best Interests? (news@vhaethics Summer 2003)
Informed
VHA Handbook 1004.01 Informed Consent for Clinical Treatments & Procedures
VHA Handbook 1004.05 iMedConsent
VHA Handbook 1004.01: Informed Consent for Clinical Treatments and Procedures (NET Summary August 2009)
Informed Consent for Methicillin-Resistant Staphylococcus Aureus (MRSA) Testing (Ethics Rx February 2009)
Informed Consent Do's and Don'ts for Best Practice (IN fOCUS August 2006)
Informed Consent for HIV Testing: Ethical Issues (NET Summary June 2004) *SUPERSEDED OR OUTDATED
Informed Consent Policy Revision (NET Summary January and February 2003) *SUPERSEDED OR OUTDATED
Informed Consent Policy Revision: Medical Decision Making in Patients Without Surrogates (NET Summary January 2002)
Informed Consent Practices: Lessons Learned from Implementing iMedConsent (NET Summary November 2006)
Informed consent - research
Sharing Aggregate Research Results with Participants (IN fOCUS March 2009)
Best Practices: Informed Consent for Research (news@vhaethics Winter 2002)
Patient-provider communication
"Teach Back": A Tool for Improving Provider-Patient Communication (IN fOCUS April 2006)
How Can Patients Communicate Their Wishes About Life-Sustaining Treatment? (Ethics Rx March 2005)
Refusal of treatment
When Patients Refuse Treatment (IN fOCUS December 2005)
Signature
Who May Serve as Witness for Signature Consent for Clinical Treatments and Procedures? (Ethics Rx December 2005)
Consent for HIV Testing: Must the Patient's Signature on VA Form 10-0121 Be Witnessed? (Ethics Rx December 2004) *SUPERSEDED OR OUTDATED
Informed Consent for IV Contrast Administration (NET Summary January 2001)
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Culture
Cultures and Persons, Patients and Caregivers: Ethical Obligations and Culturally Competent Care (NET Summary August 2003)
The Conscience Clause (NET Summary June 2002)
An Ethical Analysis of Ethnic Disparities in Health Care (NEC Report August 2001)
An Ethical Analysis of Ethnic Disparities in Health Care (NET Summary December 2002)
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Death and post-mortem
Practicing Medical Procedures on the Newly Dead (NET Summary November 2003)
Ethical Priority of Decedent's vs. Family's Wishes in Organ Donation (NET Summary July 2002)
Privacy Requirements During the Organ Donation Process (NET Summary January 2001)
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Decision-making
Capacity
Ten Myths about Decision-Making Capacity (NEC Report September 2002)
Ten Myths About Decision-Making Capacity (NET Summary November 2002)
Source Patient HIV Testing in Patients who Lack Decision-Making Capacity (NET Summary October 2002) *SUPERSEDED OR OUTDATED
Common Pitfalls in Determining Decision-Making Capacity-Live from the National Ethics Committee Meeting (NET Summary March 2001)
Shared
IntegratedEthics Online Learning Module: Shared Decision Making with Patients
Ethics Rounds: Substituted Judgment or Best Interests? (news@vhaethics Summer 2003)
Informed Consent Policy Revision: Medical Decision Making in Patients Without Surrogates (NET Summary January 2002)
Ethical Aspects of the Relationship Between Clinicians & Surrogate Decision Makers (NEC Report April 2007)
National Ethics Committee Report: Ethical Aspects of the Relationship between Clinicians & Surrogate Decision Makers (NET Summary April 2007)
May Clinicians Disclose Health Information Protected Under 38 U.S.C. §7332 to Surrogates? (Ethics Rx February 2006) *SUPERSEDED OR OUTDATED
Choosing Among Surrogates of the Same Priority (Ethics Rx April 2005)
Disclosing Patients' Protected Health Information to Surrogates (NEC Report February 2005)
Disclosing Patients' Protected Health Information (NET Summary February 2005) *SUPERSEDED OR OUTDATED
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Difficult patients
Ethics and the Discharge Process: What to Consider When a Patient Prefers a Plan that the Team Believes is Unsafe (NET Summary May 2008)
Impaired Driving in Older Adults: Ethical Challenges for Health Care Professionals (NEC Report September 2007)
National Ethics Committee Report - Impaired Driving in Older Adults: Ethical Challenges for Health Care Professionals (NET Summary September 2007)
When Patients Refuse Treatment (IN fOCUS December 2005)
Ethical Considerations When Treating Erectile Dysfunction in Patients with Sexually Transmissible Diseases (NET Summary May 2004)
Should Patients be Able to Refuse Care by House Officers or Trainees? (NET Summary March 2004)
Ethics Rounds: Patient Refusal of Care by a Trainee (news@vhaethics Summer/Fall 2002)
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Disclosure
Sharing Aggregate Research Results with Participants (IN fOCUS March 2009)
VHA Directive 2008-002 Disclosure of Adverse Events to Patients
May Clinicians Disclose Health Information Protected Under 38 U.S.C. §7332 to Surrogates? (Ethics Rx February 2006) *SUPERSEDED OR OUTDATED
Disclosing Patients' Protected Health Information to Surrogates (NEC Report February 2005)
Disclosing Patients' Protected Health Information (NET Summary February 2005) *SUPERSEDED OR OUTDATED
Disclosure of Adverse Events to Patients: Ethical and Policy Requirements (NET Summary February 2008)
Clinical Use of Placebo: An Ethics Analysis (NET Summary July 2004)
Disclosing Adverse Events to Patients (NEC Report March 2003)
National Ethics Committee Report: Disclosing Adverse Events to Patients (NET Summary April 2003)
Notification of Patients Potentially Exposed to Mad Cow Disease Through Prior Blood Transfusion: Testing the Limits of Full Disclosure (NET Summary April 2001)
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DNR (Do not Resuscitate)
VHA Handbook 1004.3 Do Not Resuscitate (DNR) Protocols within the Department of Veterans Affairs
VHA Handbook 1004.04 State-Authorized Portable Orders
State-Authorized Portable Orders: Out of Hospital DNR Orders and Orders for Life-Sustaining Treatment (NET Summary July 2007)
Adverse Events and the Management of DNR Orders: Ethical Considerations (NET Summary September 2006) *SUPERSEDED OR OUTDATED
May Do-Not-Resuscitate (DNR) Orders Be Suspended for Surgery? (Ethics Rx January 2005)
What Does DNR Really Mean? (NET Summary June 2005) DNR FAQs
Clarification of VA Do Not Resuscitate (DNR) Policy—Orders Written by Residents (Ethics Rx May 2003)
Do Not Resuscitate Policy Revision: Controversial Topics (NET Summary March 2002)
Policy Perspectives: Should Residents be Allowed to Enter DNR Orders? (news@vhaethics Summer/Fall 2002)
Catholic Teaching on Artificially Administered Nutrition & Hydration (IN fOCUS December 2004) *SUPERSEDED OR OUTDATED
Life Sustaining Treatments and Vegetative State: Implications of the March 2004 Papal Allocution for VHA Health Care (NET Summary October 2004) *SUPERSEDED OR OUTDATED
Policy Perspectives: Should Residents be Allowed to Enter DNR Orders? (news@vhaethics Summer/Fall 2002)
Family Presence During Resuscitation (NET Summary August 2001)
Ethics Rounds: Wristbands for DNR? (news@vhaethics Fall 2000)
DNR Orders and Medical Futility (NEC Report December 2000)
DNR Orders and the Electronic Medical Record (NET Summary December 2000)
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Elderly
Impaired Driving in Older Adults: Ethical Challenges for Health Care Professionals (NEC Report September 2007)
National Ethics Committee Report - Impaired Driving in Older Adults: Ethical Challenges for Health Care Professionals (NET Summary September 2007)
Provider Reporting of Impaired or Potentially Impaired Drivers (NET Summary February 2002)
Ethics and the Discharge Process: What to Consider When a Patient Prefers a Plan that the Team Believes is Unsafe (NET Summary May 28, 2008)
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Electronic communication
Online Patient-Clinician Messaging: Fundamentals of Ethical Practice (NEC Report July 2004)
National Ethics Committee Report, Online Patient-Clinician Messaging: Fundamentals of Ethical Practice (NET Summary September 2004)
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Electronic medical records/databases
The Ethical Challenges of Coordinating Mental Health Care Between VHA and DoD (NET Summary March 2006)
Patients' Requests to Have Their Medical Records Amended (NET Summary May 2006)
Copying, Pasting, and Duplicating in the Electronic Medical Record: An Ethical Analysis (NET Summary February 2004)
Access to VA Databases for Research Purposes (NET Summary February 2001)
DNR Orders and the Electronic Medical Record (NET Summary December 2000)
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End of life
General
IntegratedEthics Online Learning Module: Ethical Practices in End-of-Life Care
Weighed in the Balance: Ethical Decisions at the End of Life (news@vhaethics Spring 2001)
Ethics Rounds: Substituted Judgment or Best Interests? (news@vhaethics Summer 2003)
Informed Consent Policy Revision: Medical Decision Making in Patients Without Surrogates (NET Summary January 2002)
DNR Orders and Medical Futility (NEC Report December 2000)
Terminal Extubation: Ethics Perspectives (NET Summary March 2005)
Catholic Teaching on Artificially Administered Nutrition & Hydration (IN fOCUS December 2004) *SUPERSEDED OR OUTDATED
Legal Briefs: Must Food and Fluids Always be Provided? (news@vhaethics Fall 2000)
Goals of Care in the ICU: Palliative Care at the End of Life (IN fOCUS January 2005)
Palliative care/sedation
The Ethics of Palliative Sedation (NEC Report March 2006)
National Ethics Committee Report: The Ethics of Palliative Sedation as a Therapy of Last Resort (NET Summary July 2006)
Terminal Sedation: An Open Discussion (NET Summary August 2002)
Goals of Care in the ICU: Palliative Care at the End of Life (IN fOCUS January 2005)
Ethics Rounds: Appropriate Palliative Care? (news@vhaethics Spring 2001)
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Forms and worksheets
VA Form 10-0137 VA Advance Directive - Durable Power of Attorney for Health Care and Living Will
VA 10-0137A Your Rights Regarding Advance Directives
VA 10-0137B What You Should Know About Advance Directives
Worksheets
Advance care planning worksheets updated August 2011: Mental Health Treatment Preferences and Who to Contact
Legal Briefs: Advance Directives: VA vs. non-VA forms (news@vhaethics Spring 2001) *SUPERSEDED OR OUTDATED
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Futility
DNR Orders and Medical Futility (NEC Report December 2000)
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Genetics/genomics
The Ethics of Tissue Banking for Future Genetic Research (NET Summary July 2003)
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Goals of care
Goals of Care in the ICU: Palliative Care at the End of Life (IN fOCUS January 2005)
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Government ethics
Legal Briefs: Health Care Ethics vs. Government Ethics (news@vhaethics Winter 2001)
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HIV
Source Patient HIV Testing in Patients who Lack Decision-Making Capacity (NET Summary October 2002) *SUPERSEDED OR OUTDATED
Consent for HIV Testing: Must the Patient's Signature on VA Form 10-0121 Be Witnessed? (Ethics Rx December 2004) *SUPERSEDED OR OUTDATED
Informed Consent for HIV Testing: Ethical Issues (NET Summary June 2004) *SUPERSEDED OR OUTDATED
May Clinicians Disclose Health Information Protected Under 38 U.S.C. §7332 to Surrogates? (Ethics Rx February 2006) *SUPERSEDED OR OUTDATED
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Informed consent
General
VHA Handbook 1004.01 Informed Consent for Clinical Treatments & Procedures
The Basics of Informed Consent: History, Ethics and Law (NET Summary September 2010)
VHA Handbook 1004.01: Informed Consent for Clinical Treatments and Procedures (NET Summary August 2009)
Informed Consent Do's and Don'ts for Best Practice (IN fOCUS August 2006)
Who May Serve as Witness for Signature Consent for Clinical Treatments and Procedures? (Ethics Rx December 2005)
Ethics Rounds: Substituted Judgment or Best Interests? (news@vhaethics Summer 2003)
Informed Consent Policy Revision (NET Summary January and February 2003) *SUPERSEDED OR OUTDATED
Informed Consent Policy Revision: Medical Decision Making in Patients Without Surrogates (NET Summary January 2002)
Specific treatments, procedures or situations
Sharing Aggregate Research Results with Participants (IN fOCUS March 2009)
Informed Consent for Methicillin-Resistant Staphylococcus Aureus (MRSA) Testing (Ethics Rx February 2009)
When Must Clinicians Obtain a Separate Consent for Use of Blood Products in the Post-Operative Period? (Ethics Rx August 2006)
Consent for HIV Testing: Must the Patient's Signature on VA Form 10-0121 Be Witnessed? (Ethics Rx December 2004) *SUPERSEDED OR OUTDATED
Informed Consent for HIV Testing: Ethical Issues (NET Summary June 2004) *SUPERSEDED OR OUTDATED
Informed Consent for IV Contrast Administration (NET Summary January 2001)
"Teach Back": A Tool for Improving Provider-Patient Communication (IN fOCUS April 2006)
Best Practices: Informed Consent for Research (news@vhaethics Winter 2002)
iMedConsent
VHA Handbook 1004.05 iMedConsent
Informed Consent Practices: Lessons Learned from Implementing iMedConsent (NET Summary November 2006)
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Medical futility
DNR Orders and Medical Futility (NEC Report December 2000)
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Mental health
Advance Directives
Documenting Veterans' Mental Health Treatment Preferences in Advance Directives (Ethics Rx June 2009)
Advance Directives for Mental Health: An Ethical Analysis of State Laws & Implications for VHA Policy (NEC Report February 2008)
National Ethics Committee Report: Advance Directives for Mental Health: An Ethical Analysis of State Laws & Implications for VHA Policy (NET Summary March 26, 2008) *SUPERSEDED OR OUTDATED
Advance care planning worksheet updated August 2011: Mental Health Treatment Preferences
Must All Patients Be Asked About Mental Health Advance Directives? (Ethics Rx February 2005)
Ethical Issues in Advance Directives for Behavioral Health Care (NET Summary May 2003)
General
Ethical Considerations in the Report of a Work Group on Post Traumatic Stress Disorder (PTSD) and Vulnerable Populations in Research (NET Summary February 2009) Final Report from the PTSD work group
The Ethical Duty to Protect Third Parties from Dangerous Patients (NET Summary April 2005)
The Ethical Challenges of Coordinating Mental Health Care Between VHA and DoD (NET Summary March 2006)
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Moral distress
Moral Distress: How Can Ethics Consultants Respond? (NET Summary November 25, 2008)
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MRSA
Informed Consent for Methicillin-Resistant Staphylococcus Aureus (MRSA) Testing (Ethics Rx February 2009)
National MRSA (Methicillin-Resistant Staphylococcus Aureus) Initiative: Ethical Considerations in Implementation (NET Summary October 2007)
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Older adults
Ethics and the Discharge Process: What to Consider When a Patient Prefers a Plan that the Team Believes is Unsafe (NET Summary May 28, 2008)
Impaired Driving in Older Adults: Ethical Challenges for Health Care Professionals (NEC Report September 2007)
National Ethics Committee Report - Impaired Driving in Older Adults: Ethical Challenges for Health Care Professionals (NET Summary September 2007)
Provider Reporting of Impaired or Potentially Impaired Drivers (NET Summary February 2002)
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Opioids
General
Taking Opioids Responsibly for Your Safety and the Safety of Others: Patient Information Guide on Long-term Opioid Therapy for Chronic Pain
Ethical Considerations in Opioid Therapy for Chronic Pain (IN fOCUS April 2005)
Ethical Considerations in Opioid Therapy for Chronic Pain Management (NET Summary November 2005)
Palliative care
The Ethics of Palliative Sedation (NEC Report March 2006)
National Ethics Committee Report: The Ethics of Palliative Sedation as a Therapy of Last Resort (NET Summary July 2006)
Terminal Sedation: An Open Discussion (NET Summary August 2002)
Goals of Care in the ICU: Palliative Care at the End of Life (IN fOCUS January 2005)
Ethics Rounds: Appropriate Palliative Care? (news@vhaethics Spring 2001)
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Organ donation
Ethical Priority of Decedent's vs. Family's Wishes in Organ Donation (NET Summary July 2002)
Privacy Requirements During the Organ Donation Process (NET Summary January 2001)
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Pain management
General
Taking Opioids Responsibly for Your Safety and the Safety of Others: Patient Information Guide on Long-term Opioid Therapy for Chronic Pain
Ethical Considerations in Opioid Therapy for Chronic Pain (IN fOCUS April 2005)
Ethical Considerations in Opioid Therapy for Chronic Pain Management (NET Summary November 2005)
Palliative care
The Ethics of Palliative Sedation (NEC Report March 2006)
National Ethics Committee Report: The Ethics of Palliative Sedation as a Therapy of Last Resort (NET Summary July 2006)
Terminal Sedation: An Open Discussion (NET Summary August 2002)
Goals of Care in the ICU: Palliative Care at the End of Life (IN fOCUS January 2005)
Ethics Rounds: Appropriate Palliative Care? (news@vhaethics Spring 2001)
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Palliative care
The Ethics of Palliative Sedation (NEC Report March 2006)
National Ethics Committee Report: The Ethics of Palliative Sedation as a Therapy of Last Resort (NET Summary July 2006)
Terminal Sedation: An Open Discussion (NET Summary August 2002)
Goals of Care in the ICU: Palliative Care at the End of Life (IN fOCUS January 2005)
Ethics Rounds: Appropriate Palliative Care? (news@vhaethics Spring 2001)
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Pandemic influenza
Meeting the Challenge of Pandemic Influenza: Ethical Guidance for Leaders and Health Care Professionals in the Veterans Health Administration (VHA) (July 2010)
VA FACT SHEET FOR HEALTH CARE STAFF: Meeting the Ethical Challenges of a Severe Pandemic Influenza
Ethical Considerations for Resource Allocation in Health Care (NET Summary May 27, 2009 and June 30, 2009)
Influenza Pandemic Preparedness Planning: Ethics Concerns (NET Summary June 2006)
STAFF DISCUSSION FORUM MATERIALS: Ethical Issues in Pandemic Influenza Preparedness and Response – Material to Guide Staff Discussions
Tough Decisions: Preparing VA for the Ethical Challenges of Pandemic Influenza
Best Practices: A Duty to Treat (news@vhaethics Fall 2003)
Health Care Ethics Issues Raised by SARS (NET Summary June 2003)
Ethics Rounds: Taking Risks to Protect Patients (news@vhaethics Fall 2003)
Disaster Medicine: Unique Ethical Challenges (NET Summary April 2002)
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Patients -
Difficult
Ethical Considerations That Arise When a Home Care Patient on Long Term Oxygen Therapy Continues to Smoke (March 2010)
Ethical Considerations in the use of Home Oxygen for Patients and/or Third Parties Who Smoke (NET Summary July 30, 2008)
Ethics and the Discharge Process: What to Consider When a Patient Prefers a Plan that the Team Believes is Unsafe (NET Summary May 28, 2008)
Home Oxygen for Patients Who Smoke: Prescription vs. Proscription (NET Summary October 2001)
When Patients Refuse Treatment (IN fOCUS December 2005)
Ethical Considerations in Opioid Therapy for Chronic Pain (IN fOCUS April 2005)
Ethical Considerations in Opioid Therapy for Chronic Pain Management (NET Summary November 2005)
The Ethical Duty to Protect Third Parties from Dangerous Patients (NET Summary April 2005)
Ethics Rounds: Patient Refusal of Care by a Trainee (news@vhaethics Summer/Fall 2002)
Managing 'Difficult' or 'Non-Compliant' Patients: Ethical Challenges (NET Summary September 2001)
Limits to patient choice
When Patients Refuse Treatment (IN fOCUS December 2005)
DNR Orders and Medical Futility (NEC Report December 2000)
Ethical Considerations When Treating Erectile Dysfunction in Patients with Sexually Transmissible Diseases (NET Summary May 2004)
Should Patients be Able to Refuse Care by House Officers or Trainees? (NET Summary March 2004)
Ethics Rounds: Patient Refusal of Care by a Trainee (news@vhaethics Summer/Fall 2002)
Safety
Impaired Driving in Older Adults: Ethical Challenges for Health Care Professionals (NEC Report September 2007)
National Ethics Committee Report - Impaired Driving in Older Adults: Ethical Challenges for Health Care Professionals (NET Summary September 2007)
Provider Reporting of Impaired or Potentially Impaired Drivers (NET Summary February 2002)
Ethical Considerations That Arise When a Home Care Patient on Long Term Oxygen Therapy Continues to Smoke (March 2010)
Ethical Considerations in the use of Home Oxygen for Patients and/or Third Parties Who Smoke (NET Summary July 30, 2008)
Home Oxygen for Patients Who Smoke: Prescription vs. Proscription (NET Summary October 2001)
The Ethical Duty to Protect Third Parties from Dangerous Patients (NET Summary April 2005)
Unsafe discharge
Ethics and the Discharge Process: What to Consider When a Patient Prefers a Plan that the Team Believes is Unsafe (NET Summary May 28, 2008)
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Persistent vegetative state
Caring for Patients in Persistent Vegetative State (IN fOCUS March 2005)
Life Sustaining Treatments and Vegetative State: Implications of the March 2004 Papal Allocution for VHA Health Care (NET Summary October 2004) *SUPERSEDED OR OUTDATED
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Physician assisted suicide
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Policies
VHA Directive 1004 National Center for Ethics in Health Care
VHA Handbook 1004.01 Informed Consent for Clinical Treatments & Procedures
VHA Handbook 1004.02 Advance Care Planning and Management of Advance Directives
VHA Handbook 1004.3 Do Not Resuscitate (DNR) Protocols within the Department of Veterans Affairs
VHA Handbook 1004.04 State-Authorized Portable Orders
VHA Handbook 1004.05 iMedConsent
VHA Handbook 1004.06 IntegratedEthics
VHA Handbook 1004.07 Financial Relationships Between VHA Health Care Professionals and Industry
VHA Directive 2008-002 Disclosure of Adverse Events to Patients
IL 10-2010-02 January 13, 2010 Intimidating and Disruptive Behaviors That Undermine a Culture of Patient Safety
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Post traumatic stress disorder
Ethical Considerations in the Report of a Work Group on Post Traumatic Stress Disorder (PTSD) and Vulnerable Populations in Research (NET Summary February 2009) Final Report from the PTSD work group
The Ethical Challenges of Coordinating Mental Health Care Between VHA and DoD (NET Summary March 2006)
The Ethical Duty to Protect Third Parties from Dangerous Patients (NET Summary April 2005)
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Privacy and confidentiality
General
IntegratedEthics Online Learning Module: Patient Privacy and Confidentiality
The Ethical Challenges of Coordinating Mental Health Care Between VHA and DoD (NET Summary March 2006)
May Clinicians Disclose Health Information Protected Under 38 U.S.C. §7332 to Surrogates? (Ethics Rx February 2006) *SUPERSEDED OR OUTDATED
Disclosing Patients' Protected Health Information to Surrogates (NEC Report February 2005)
Disclosing Patients' Protected Health Information (NET Summary February 2005) *SUPERSEDED OR OUTDATED
Privacy, Safety and Patient Social Security Numbers: Ethics Concerns (NET Summary July 2005)
Privacy, Safety, and Social Security Numbers (IN fOCUS February 2005)
Note: Since this IN fOCUS was published, VHA Directive 2005-029, Transfusion Verification and Identification Requirements for All Sites (July 1, 2005) has been issued. It requires that "all patients reporting for hospital admission or ambulatory procedure must be issued a patient identification wristband that contains the patient's full name, full social security number (SSN) and a bar code that displays the patient's full SSN."
Other
Patients' Requests to Have Their Medical Records Amended (NET Summary May 2006)
Online Patient-Clinician Messaging: Fundamentals of Ethical Practice (NEC Report July 2004)
National Ethics Committee Report, Online Patient-Clinician Messaging: Fundamentals of Ethical Practice (NET Summary September 2004)
Ethics Rounds: Wristbands for DNR? (news@vhaethics Fall 2000)
Privacy Requirements During the Organ Donation Process (NET Summary January 2001)
Access to VA Databases for Research Purposes (NET Summary February 2001)
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Professionalism
General
The Place of Codes of Ethics in Ethics Consultation (NET Summary May 2010)
Core Competencies for Health Care Ethics Consultation (NET Summary March 24, 2010)
IL 10-2010-02 January 13, 2010 Intimidating and Disruptive Behaviors That Undermine a Culture of Patient Safety
IntegratedEthics Online Learning Module, Professionalism in Patient Care
The Interplay Between Patient Advocacy and Health Care Ethics (NET Summary March 25, 2009)
Online Patient-Clinician Messaging: Fundamentals of Ethical Practice (NEC Report July 2004)
National Ethics Committee Report, Online Patient-Clinician Messaging: Fundamentals of Ethical Practice (NET Summary September 2004)
Best Practices: A Duty to Treat (news@vhaethics Fall 2003)
Ethics Rounds: Taking Risks to Protect Patients (news@vhaethics Fall 2003)
Best Practices: Teaching Ethics and Professionalism (news@vhaethics Summer/Fall 2002)
The Conscience Clause (NET Summary June 2002)
Conflicts of interest
VHA Handbook 1004.07 Financial Relationships Between VHA Health Care Professionals and Industry
VHA Handbook 1004.07: Financial Relationships Between VHA Health Care Professionals and the Pharmaceutical Industry (NET Summary November 24, 2009)
Compensation to Health Care Professionals from the Pharmaceutical Industry (NEC Report February 2006)
National Ethics Committee Report: Compensation to Health Care Professionals from the Pharmaceutical Industry (NET Summary February 2006)
Ethical Boundaries in the Patient-Clinician Relationship (NEC Report July 2003)
National Ethics Committee Report: Ethical Boundaries in the Patient Clinician Relationship (NET Summary September 2003)
Gifts to Health Care Professionals from the Pharmaceutical Industry (NEC Report October 2003)
National Ethics Committee Report: Gifts to Health Care Professionals from the Pharmaceutical Industry (NET Summary January 2004)
Ethics Rounds: Sale of House to a Patient? (news@vhaethics Winter 2001)
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Quality improvement
Recommendations for the Ethical Conduct of Quality Improvement (NEC Report May 2002)
Recommendations for the Ethical Conduct of Quality Improvement (NET Summary September 2002)
Ethics Rounds: A Case of Quality Improvement (news@vhaethics Winter 2002)
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Religion
Catholic Teaching on Artificially Administered Nutrition & Hydration (IN fOCUS December 2004) *SUPERSEDED OR OUTDATED
Life Sustaining Treatments and Vegetative State: Implications of the March 2004 Papal Allocution for VHA Health Care (NET Summary October 2004) *SUPERSEDED OR OUTDATED
Cultures and Persons, Patients and Caregivers: Ethical Obligations and Culturally Competent Care (NET Summary August 2003)
An Ethical Analysis of Ethnic Disparities in Health Care (NEC Report August 2001)
An Ethical Analysis of Ethnic Disparities in Health Care (NET Summary December 2002)
The Conscience Clause (NET Summary June 2002)
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Research
Sharing Aggregate Research Results with Participants (IN fOCUS March 2009)
Ethical Considerations in the Report of a Work Group on Post Traumatic Stress Disorder (PTSD) and Vulnerable Populations in Research (NET Summary February 2009) Final Report from the PTSD work group
The Ethics of Tissue Banking for Future Genetic Research (NET Summary July 2003)
Best Practices: Informed Consent for Research (news@vhaethics Winter 2002)
Access to VA Databases for Research Purposes (NET Summary February 2001)
Legal Briefs: The HIPAA Privacy Rule and its Impact on Research (news@vhaethics Winter 2002)
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Resource allocation
General
IntegratedEthics Online Learning Module, Ethical Practices in Resource Allocation
Macroallocation
Meeting the Challenge of Pandemic Influenza: Ethical Guidance for Leaders and Health Care Professionals in the Veterans Health Administration (VHA) (July 2010)
VA FACT SHEET FOR HEALTH CARE STAFF: Meeting the Ethical Challenges of a Severe Pandemic Influenza
Ethical Considerations for Resource Allocation in Health Care (NET Summary May 27, 2009 and June 30, 2009)
Influenza Pandemic Preparedness Planning: Ethics Concerns (NET Summary June 2006)
STAFF DISCUSSION FORUM MATERIALS: Ethical Issues in Pandemic Influenza Preparedness and Response – Material to Guide Staff Discussions
Tough Decisions: Preparing VA for the Ethical Challenges of Pandemic Influenza
Policy Perspectives: The Administrator's Dilemma (news@vhaethics Fall 2003)
Foglia MB, Pearlman RA, Bottrell MM, Altemose JA, Fox E. Priority Setting and the Ethics of Resource Allocation within VA Healthcare Facilities: Results of a Survey. Organizational Ethics. 2008 Fall-Winter;4(2):83-96. (based on research conducted as part of the IESS).
Microallocation
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Shared/group medical appointments
Shared Medical Appointments: Ethical Concerns (NET Summary October 2005)
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Social security numbers
Privacy, Safety and Patient Social Security Numbers: Ethics Concerns (NET Summary July 2005)
Privacy, Safety, and Social Security Numbers (IN fOCUS February 2005)
Note: Since this IN fOCUS was published, VHA Directive 2005-029, Transfusion Verification and Identification Requirements for All Sites (July 1, 2005) has been issued. It requires that "all patients reporting for hospital admission or ambulatory procedure must be issued a patient identification wristband that contains the patient's full name, full social security number (SSN) and a bar code that displays the patient's full SSN."
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Suicide
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Surrogates
Ethical Aspects of the Relationship Between Clinicians & Surrogate Decision Makers (NEC Report April 2007)
National Ethics Committee Report: Ethical Aspects of the Relationship between Clinicians & Surrogate Decision Makers (NET Summary April 2007)
May Clinicians Disclose Health Information Protected Under 38 U.S.C. §7332 to Surrogates? (Ethics Rx February 2006) *SUPERSEDED OR OUTDATED
Choosing Among Surrogates of the Same Priority (Ethics Rx April 2005)
Disclosing Patients' Protected Health Information to Surrogates (NEC Report February 2005)
Disclosing Patients' Protected Health Information (NET Summary February 2005) *SUPERSEDED OR OUTDATED
Ethics Rounds: Substituted Judgment or Best Interests? (news@vhaethics Summer 2003)
Informed Consent Policy Revision: Medical Decision Making in Patients Without Surrogates (NET Summary January 2002)
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Terminal sedation
The Ethics of Palliative Sedation (NEC Report March 2006)
National Ethics Committee Report: The Ethics of Palliative Sedation as a Therapy of Last Resort (NET Summary July 2006)
Terminal Sedation: An Open Discussion (NET Summary August 2002)
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Truth telling
VHA Directive 2008-002 Disclosure of Adverse Events to Patients
Disclosure of Adverse Events to Patients: Ethical and Policy Requirements (NET Summary February 2008)
Clinical Use of Placebo: An Ethics Analysis (NET Summary July 2004)
Disclosing Adverse Events to Patients (NEC Report March 2003)
National Ethics Committee Report: Disclosing Adverse Events to Patients (NET Summary April 2003)
Notification of Patients Potentially Exposed to Mad Cow Disease Through Prior Blood Transfusion: Testing the Limits of Full Disclosure (NET Summary April 2001)
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VA/DoD
The Ethical Challenges of Coordinating Mental Health Care Between VHA and DoD (NET Summary March 2006)
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VA staff
General
Strategies for Increasing Influenza Vaccination Rates in Health Care Workers: Ethical Considerations (NET Summary January 30, 2008)
Practicing Medical Procedures on the Newly Dead (NET Summary November 2003)
Residents/trainees
Clarification of VA Do Not Resuscitate (DNR) Policy—Orders Written by Residents (Ethics Rx May 2003)
Policy Perspectives: Should Residents be Allowed to Enter DNR Orders? (news@vhaethics Summer/Fall 2002)
Should Patients be Able to Refuse Care by House Officers or Trainees? (NET Summary March 2004)
Ethics Rounds: Patient Refusal of Care by a Trainee (news@vhaethics Summer/Fall 2002)
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Worksheets
Advance care planning worksheets updated August 2011: Mental Health Treatment Preferences and Who to Contact
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