Bystander Ethics and Good Samaritanism: A Paradox for Learning Health Organizations.
Anticoagulants
/ therapeutic use
Atrial Fibrillation
/ therapy
Delivery of Health Care
/ ethics
Ethics, Research
Health Knowledge, Attitudes, Practice
Health Plan Implementation
/ ethics
Health Services Misuse
/ prevention & control
Health Services Research
/ methods
Humans
Patient Care
/ ethics
Quality Improvement
/ organization & administration
Research
Treatment Outcome
Journal
The Hastings Center report
ISSN: 1552-146X
Titre abrégé: Hastings Cent Rep
Pays: United States
ID NLM: 0410447
Informations de publication
Date de publication:
07 2019
07 2019
Historique:
entrez:
21
8
2019
pubmed:
21
8
2019
medline:
6
10
2020
Statut:
ppublish
Résumé
In 2012, a U.S. Institute of Medicine report called for a different approach to health care: "Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets." The answer, they suggested, would be a "continuously learning" health system. Ethicists and researchers urged the creation of "learning health organizations" that would integrate knowledge from patient-care data to continuously improve the quality of care. Our experience with an ongoing research study on atrial fibrillation-a trial known as IMPACT-AFib-gave us some insight into one of the challenges that will have to be dealt with in creating these organizations. Although the proposed educational intervention study placed no restrictions on what providers and health plans could do, the oversight team argued that the ethical principle of beneficence did not allow the researchers to be "bystanders" in relation to a control group receiving suboptimal care. In response, the researchers designed a "workaround" that allowed the project to go forward. We believe the experience suggests that what we call "bystander ethics" will create challenges for the kinds of quality improvement research that LHOs are designed to do.
Substances chimiques
Anticoagulants
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
18-26Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2019 The Hastings Center.
Références
National Academies of Sciences, Engineering, Medicine, Health and Medicine Division, “Report Brief,” September 6, 2012, http://www.nationalacademies.org/hmd/Reports/2012/Best-Care-at-Lower-Cost-The-Path-to-Continuously-Learning-Health-Care-in-America/Report-Brief.aspx?page=2.
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