ATS members and others involved in the clinical practice of pulmonary medicine, critical care, and sleep medicine face complex ethical questions regularly. These challenges have led to an increasing amount of activities within the ATS that concern relevant issues and are intended to advise and assist clinicians, patients and families as they address them. For example, in recent years official ATS statements have been published on shared decision making, managing conscientious objections, responding to requests for potentially inappropriate therapies, ethical considerations in organ donation, and palliative care. Ethical issues have been discussed in manuscripts published in ATS journals and in sessions at the annual ATS International Conference, and a series of periodic Committee-developed podcasts on clinical ethics issues.
Clinical ethics resources specific to the COVID-19 pandemic are currently listed and linked within a special ATS COVID-19 Resources listing. Opinions expressed and resources shared may not have been reviewed by the ATS prior to distribution through ATS channels, or reflect official positions of the ATS, unless it is explicitly stated as such, after official ATS approval. References to specific commercial entities (companies) or products do not reflect review or endorsement by the ATS unless it is explicitly noted as such, after official ATS approval.
ATS Publications (official ATS statements and other relevant manuscripts published in ATS Journals; in chronological order):
- An Official ATS/ACCM Statement: Shared Decision Making in ICUs (2016)
- An ATS Statement: Tobacco Control and Treatment (2015)
- An ATS Policy Statement: Managing conscientious objections in the ICU (2015)
- An Official ATS/AACN/ACCP/ESICM/SCCM Statement: Responding to requests for potentially inappropriate therapies in the ICU (2015)
- An Official American Thoracic Society Workshop Report: Assessment and Palliative Management of Dyspnea Crisis (2013)
- An
Official ATS / ISHLT / SCCM / AOPO / UNOS Policy Statement: Ethical and
Policy Considerations in Organ Donation after Circulatory Determination
of Death (2013)
- Scheunemann LP, Arnold RM, White DB. The facilitated values history: helping surrogates make authentic decisions for incapacitated patients with advanced illness. Am J Respir Crit Care Med. 2012;186(6):480-6; PMID: 22822020 (2012)
- White DB, Evans LR, Bautista CA, et al. Are physicians’ recommendations to limit life support beneficial or burdensome? Bringing empirical data to the debate. Am J Respir Crit Care Med. 2009;180:320-5. (2009)
- An Official ATS Policy Statement: Managing Conflict of Interest in Professional Societies (2009)
- An
Official American Thoracic Society Clinical Policy Statement:
Palliative Care for Patients with Respiratory Diseases and Critical
Illnesses (2008)
ATS Podcasts
- How do I know what to disclose? Common questions about managing professional relationships with industry and other partners.
January 2019 - Medical Ethics Education
May 2018 - Clinical Ethics in Critical Care: Surrogate Decision Makers
December 2017 - Clinical
Ethics in Critical Care: Is it ethically acceptable to honor previous
wishes to withhold life-sustaining treatments in the setting of
suspected suicide?
June 2017
Other podcasts addressing clinical ethics issues, developed by ATS Assemblies and others, are available at Breathe Easy Podcasts.
ATS International Conference Sessions (available in the ATS Store):
See “Best of the ATS International Conference” at http://store.thoracic.org/
Non-ATS Publications:
- Billings JA, Block SD. The end-of-life family meeting in intensive care part III: A guide for structured discussions. J Palliat Med 2011; 14:1058-64. PMID: 21910613 (2011)
- Truog RD, Campbell ML, Curtis JR, et al. Recommendations for end-of-life care in the intensive care unit: a consensus statement by the American College of Critical Care Medicine. Crit Care Med 2008; 36:953-63. PMID: 18431285 (2008)
- Lautrette A, Darmon M, Megarbane B, et al. A communication strategy and brochure for relatives of patients dying in the ICU. N Engl J Med 2007; 356:469-78. This French study of family members of 126 patients that died in an ICU found the use of a brochure on bereavement combined with a proactive communication strategy lowered symptoms of anxiety, depression, and PTSD. PMID: 17267907 (2007)
- Tonelli MR. Pulling the plug on living wills. Chest 1996;110:816-22. Discusses the difficulties and limitations of formulating and applying advanced directives. PMID: 8797430. (1996)
Non-ATS Online Resources:
- National Institutes of Health, Clinical Center Department of Bioethics
- American College of Physicians, Ethics and Professionalism
- American Medical Association, Journal of Ethics
- American Nurses Association
Question or suggestions for the ATS Ethics and COI Committee
Contact Shane McDermott at ATS at smcdermott@thoracic.org or 212-315-8650.