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Palliative Care Research: Ethics Analysis Annotated Bibliography

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Duke, S., & Bennett, H. (2010). A narrative review of the published ethical debates in palliative care research and an assessment of their adequacy to inform research governance. Palliative medicine, 24(2), 111-126.

The authors explore how the quality of research, along with the available evidence in guiding palliative care largely relies on ethical decisions that inform its conduction, designing, and reporting. Even as there is a lot of published work on the ethical debate of palliative care research, nonetheless, there still lacks in literature a synthesis and exploration of the quality of the central debates. These central debates include moral appropriateness, inclusion, gate-keeping, vulnerability, and research culture. Limited debate exists on research reporting ethics as well as the ethics supporting research leadership. The study offers a framework to enhance a reconciliation of emerging ethical issues in addition to an identification of possible methodological approaches.

Gardiner, C., Barnes, S., Small, N., Gott, M., Payne, S., Seamark, D., & Haplin, D. (2010). Reconciling informed consent and ‘do no harm’: ethical challenges in palliative-care research and practice in chronic obstructive pulmonary disease. Palliat Med,24(5), 469-472

In their paper, the authors emphasizes on the ethical challenges associated with research involving palliative care patients. In this regard, the study discuses these challenges in the form of a pilot study aimed at assessing the needs of the palliative care patients experiencing severe and moderate obstructive pulmonary disease. In the study, the main ethical problems that the subjects were faced with involved issues to do with the application of terminology, and more so the terms ‘chronic obstructive pulmonary disease’ and ‘palliative care’. The impact that the ethical advice given to the patients is also examined and its capability to provide them with a total informed consent.

Jubb, A. (2002). Palliative care research: trading ethics for an evidence base. J Med Ethics, 28, 342-346

In this article, Jubb argues that the evidence of effectiveness is often required in god medical practice to address care deficiencies, justly distribute limited resources, and endeavor for further improvements. However, a scarcity of good evidence often hinders the potential for palliative care. Jubb contends that such circumstances are mainly due to perceived challenges that supposedly categorize dying patients in a special class of their own. The critic by Jubb is an attempt to consider the need for undertaking focused studies with the intention of developing policy and clinical decisions with a view to guiding professionals within the health care sector as they attend to dying patients. The author also examines the principles behind the ethical and practical challenges regarding palliative care research, and regards them as insurmountable and unique. In summary, the review argues that a compassionate application of the ethical principles by investigators in their work is a sign of an endeavor to enhance the quality of palliative care provisions by taking part in research.

Keeley, P. W. (2008). Improving the evidence base in palliative medicine: a moral imperative. J Med Ethics, 34, 757-760.

In his article, Keeley documents the challenges involved in carrying out sound quality effectiveness in as far as palliative medicine is concerned. He further argues that most of the available literature on this topic emphasizes on how vulnerable the population under palliative care is. In this case, Keeley talks of the need to utilize a wider ethical approach to validate undertaking research on the terminally ill. He has also talked of the underutilization of certain themes regarding ethical thoughts in as far as the ethical issues of palliative care research are concerned. On the basis of the modern day evidence base regarding how effective palliative care is, we find ourselves in a somewhat compromised position in which patients under palliative care becomes the unsuspecting subjects of clinical trial, even when they have not given their consent.

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