Management of patients with Do Not Resuscitate/Do Not Intubate orders in the acute or perioperative phase of care is an extremely complex issue. In this episode I discuss how clinicians can manage these often challenging situations. 

• Automatic suspension of DNR/DNI orders is morally questionable
• Learn how to navigate these complex discussions with patients
• Learn how to navigate these complex discussions with fellow clinicians
• How do we prioritize patient autonomy in this situations 

AMA Journal of Ethics: Perioperative Do-Not-Resuscitate Orders 

Weekly episodes will help you learn to navigate ethical dilemmas. You will learn how to be considerate of other cultures and perspectives that our patients may have. You will be empowered to provide the most current ethical and equitable care to your patients.

Subscribe, listen to and share Curbside Ethics. If you have any specific topics or issues contact me directly on my website where I provide individualized consultations.

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Is it ethical to require COVID-19 Vaccination prior to organ transplantation? This concept blew up in the news recently after several viral headlines. Lets dig a little deeper and look beneath the politics and the fake news. What are some of the actual requirements to be listed for transplant?

• Learn about the requirements to be listed for transplant.
• Did you know that family members of transplant patients may be required to be vaccinated prior to listing for transplant?
• How does this requriement line up with other requirements?

Welcome to Curbside Ethics. So happy you tuned in. Please share with your fellow clinicians and leave a rating or comment on iTunes. Visit www.StevenBradleyMD.com to request a personalized ethics consultation from our host.

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As the COVID-19 pandemic peaks once again and the Delta variant fills hospitals across the country, there has been some talk of triaging patients based upon their vaccination status. Obviously this raises many ethical issues.

In this episode I review some of the implications raised by this potential contingency. Fundamentally, it is unethical to triage based upon vaccination status. At the moment, there is limited data regarding morbidity and mortality of matched cohort patients when comparing critically ill vaccinated vs unvaccinated. This data is being gathered, but at this point there is not enough to support triaging on this basis. Additionally there are some patients that are unable to be vaccinated due to medical comorbidities or status as a minor. Concessions would have to be made for each of these various circumstances.

What are your thoughts on triaging care based upon a patient's vaccination status?

Welcome to Curbside Ethics. So happy you tuned in. Please share with your fellow clinicians and leave a rating or comment on iTunes. Visit www.StevenBradleyMD.com to request a personalized ethics consultation from our host.

Hosted on Acast. See acast.com/privacy for more information.

This episoe continues with a similar subject matter, "Vaccines". In the wake of vaccine mandates, religious and personal objections are on the rise. What do certain religions belive about vaccination. I summarized several resources which provide a good overview of several religious stances on vaccines. 

Vanderbilt University Medical Center has a website that breaks down this topic by religion.

The Johns Hopkins Bloomberg School of Public health has additional information.

The Christian Medical and Dental Association provides additional background on the topic of vaccine contents and aborted fetal tissue. 

I would love to hear your thoughts on this issue!

Welcome to Curbside Ethics. So happy you tuned in. Please share with your fellow clinicians and leave a rating or comment on iTunes. Visit www.StevenBradleyMD.com to request a personalized ethics consultation from our host.

Hosted on Acast. See acast.com/privacy for more information.

Vaccine mandates are on the way. They are coming to many business in the private sector and even to cities and communities. The US military and the Department of Defense has announced impending mandates for service members. This is a special population with slightly different contrstraints compared to civilians. 

This episode explores the historical precedent of controversial mandatory vaccination in the military. I discuss the implementation of mandatory Anthrax vaccination and where that program currently stands. 

I would love to hear your thoughts on this issue!

Welcome to Curbside Ethics. So happy you tuned in. Please share with your fellow clinicians and leave a rating or comment on iTunes. Visit www.StevenBradleyMD.com to request a personalized ethics consultation from our host.

Hosted on Acast. See acast.com/privacy for more information.

Excited to share this episode and hopefully clear up some misconceptions surrounding COVID-19 Vaccine Mandates. The conversation starts with discussing if vaccine mandates are legal and ethical. (Spoiler alert, they are!!).

This discussion centers around finding accurate information. The Equal Employment Opportunity Commission has a wealth of resources and answers many FAQ's regarding your rights in the workplace and what accomodations should be made. 

I discuss the recent policies from the NFL and NYC regarding restrictions and repercussions for those that are not vaccinated. Health equity is always a concern and equal access to this vaccine MUST be achieved to ensure mandates do not disproportionately affect disadvantated people groups.

I would love to hear your thoughts on this issue!

Welcome to Curbside Ethics. So happy you tuned in. Please share with your fellow clinicians and leave a rating or comment on iTunes. Visit www.StevenBradleyMD.com to request a personalized ethics consultation from our host.

Hosted on Acast. See acast.com/privacy for more information.

Health equity is a topic featured frequently on this podcast. We have watched a renewed emphasis on healthcare disparities and health inequity with the advent of the COVID-19 pandemic. As the vaccines were rolled out, we watched once again as inequity reared its ugly head. Vulnerable populations were often late to receive access to the vaccines and often had to overcome significant obstacles to be vaccinated.

Although vaccine inequity still exists in the US, over half of our adult population has received at least one dose of a COVID-19 vaccine, there is still work to be done. 

In this episode, I shift the focus to Global COVID-19 Vaccine equity. How does the US and other developed countries compare to our fellow humans in countries that have low to mid socio-economic status. What can (and should) we do to correct this global disparity. 

Welcome to Curbside Ethics. So happy you tuned in. Please share with your fellow clinicians and leave a rating or comment on iTunes. Visit www.StevenBradleyMD.com to request a personalized ethics consultation from our host.

Hosted on Acast. See acast.com/privacy for more information.

Evaluating patient capacity is a common issue in clinical medical ethics. How do we dow what's best for patients and respect their autonomy while ensuring they are indeed able to make their own medical decisions. 

This situations often occur acutely with little time to deliberate. Prepare in advance by listening to this podcast and determining a course of action. 

1. Have a conversation to evaluate the capacity and understanding.
2. Understand a patient's overall wishes with regards to their health and lifestyle.
3. Use a "sliding scale" approach where complex, high-risk decisions require a higher level of "capacity" as opposed to lower-risk les significant decisions. 
4. Determine if mental statuse changes are acute or chronic, reversible or irreversible. 

Welcome to Curbside Ethics. So happy you tuned in. Please share with your fellow clinicians and leave a rating or comment on iTunes. Visit www.StevenBradleyMD.com to request a personali zed ethics consultation from our host.

Hosted on Acast. See acast.com/privacy for more information.