Calling on the USPSTF to Address Ableism and Structural Ableism

Creation to Dissemination: A Roadmap for Health Equity Research

Health equity is the point at which all individuals have an equal opportunity to experience optimal health and thriving. The current state of health care is far from this ideal as numerous populations experience health disparities: differences in health or health outcomes that negatively impact groups who experience systemic disadvantage. All research has the potential to widen, maintain, or close health disparities. This article focuses on key opportunities for hospitalists of all levels of research experience to conduct research that promotes health equity from project planning to disseminating results. During the planning phase, learning health equity research concepts, developing study designs in partnership with communities, and recognizing the limitations of secondary analyses are key strategies that promote health equity. Developing strategies for recruiting populations underrepresented in research helps ensure that disparities in health outcomes are identified. Rather than conducting descriptive research to identify disparities, research which aims to improve health outcomes for groups that have been marginalized is urgently needed. Study analyses should consider intersectionality and patient-centered outcomes. Finally, dissemination to both academic and community audiences, with careful attention to words and figures, can catalyze future directions, mitigate bias, and help ensure that marginalized communities benefit equitably from research findings.

Exploring Ethical Dimensions in Neuropalliative Care

Neurologic illnesses can be challenging to diagnose, involve changes in consciousness, and are often complicated by prognostic uncertainty. These disorders can affect how individuals interact with their environment, and as a result, many ethical concerns may arise related to their medical care. Key ethical issues in neuropalliative care include shared decision-making, evolving autonomy and capacity, best interest and harm principles, beneficence and nonmaleficence, futile and inappropriate care, justice and equity, and ableism. The four core principles of medical ethics, beneficence, nonmaleficence, justice, and autonomy, are foundational in considering approaches to these ethical challenges. Shared decision-making is rooted in the principle of autonomy. Evolving autonomy and capacity evoke autonomy, beneficence, and nonmaleficence. The best interest and harm principles are rooted in beneficence and nonmaleficence. Questions of futility and inappropriate care are founded in the principles of nonmaleficence, autonomy, and justice. Ableism invokes questions of nonmaleficence, autonomy, and justice. Practitioners of neurology will encounter ethical challenges in their practice. Framing decisions around the core ethical principles of beneficence, nonmaleficence, autonomy, and justice will help clinicians navigate challenging situations while acknowledging and respecting each patient's individual story.

National Institutes of Health Designates Disabled People a Health Disparity Population

This Viewpoint examines watershed moments in improving health care for people with disabilities in the US.

Tackling Brain and Muscle Dysfunction in Acute Respiratory Distress Syndrome Survivors: NHLBI Workshop Report

Acute respiratory distress syndrome (ARDS) is associated with long-term impairments in brain and muscle function that significantly impact the quality of life of those who survive the acute illness. The mechanisms underlying these impairments are not yet well understood, and evidence-based interventions to minimize the burden on patients remain unproved. The NHLBI of the NIH assembled a workshop in April 2023 to review the state of the science regarding ARDS-associated brain and muscle dysfunction, to identify gaps in current knowledge, and to determine priorities for future investigation. The workshop included presentations by scientific leaders across the translational science spectrum and was open to the public as well as the scientific community. This report describes the themes discussed at the workshop as well as recommendations to advance the field toward the goal of improving the health and well-being of ARDS survivors.