title: Reconciling informed consent and 'do no harm': ethical challenges in palliative-care research and practice in chronic obstructive pulmonary disease.
abstract: The challenges associated with patient-based research in palliative care are well documented. This paper focuses on the ethical challenges and discusses them in the context of a pilot study to explore the palliative-care needs of patients with moderate and severe chronic obstructive pulmonary disease. The main ethical challenge encountered related to problems surrounding the use of terminology, specifically the terms 'palliative care' and 'chronic obstructive pulmonary disease'. The approving ethics committee specified that these terms be removed from all patient materials in order to protect patients from undue distress. The impact of this ethical advice on patients' ability to give fully informed consent is discussed. This paper highlights a requirement for appropriately resourced and well-managed studies in palliative care, and identifies a need for the development of appropriate strategies in order to ensure the informed participation of patients with non-cancer diagnoses in palliative-care research.
authors.affiliation: School of Nursing and Midwifery, University of Sheffield, Sheffield, UK. c.gardiner@sheffield.ac.uk
authors.forename: Clare
authors.initials: C
authors.lastname: Gardiner
authors.forename: Sarah
authors.initials: S
authors.lastname: Barnes
authors.forename: Neil
authors.initials: N
authors.lastname: Small
authors.forename: Merryn
authors.initials: M
authors.lastname: Gott
authors.forename: Sheila
authors.initials: S
authors.lastname: Payne
authors.forename: David
authors.initials: D
authors.lastname: Seamark
authors.forename: David
authors.initials: D
authors.lastname: Halpin
mesh_terms: D002986:Clinical Trials as Topic / Q000941:ethics*; D004992:Ethics, Medical; D006801:Humans; D007258:Informed Consent / Q000941:ethics*; D010166:Palliative Care / Q000941:ethics* / Q000592:standards; D010865:Pilot Projects; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*