We argue that the Joining Forces study was a morally risky, but ethically earnest effort to reach a neglected patient population and promote behavior change in prayer camp staff. Third, we identify an open ethical question born of the researchers' commitment to pragmatism that, to our knowledge, has not been previously addressed in published discussion of the Joining Forces project. Namely, was the incomplete disclosure of information to prayer camp staff defensible? We close with a broader reflection on the notion of moral integrity in the pursuit of the salutary aims of global health.Rapidly advancing technologies in the field of extracorporeal cardiopulmonary resuscitation (ECPR) have presented a new challenge in accurate neuroprognostication following cardiac arrest. Determination of brain state informs the prognostic picture and allows providers to begin effective communication regarding likelihood of meaningful neurological recovery as defined by patients or family members. The evolving role of sedation during ECPR and its impacts on ethical tension in decision-making is reviewed. Work surrounding the advancing field of neuroprognostication after cardiac arrest and hypothermia is summarized and implications of premature withdrawal of life-sustaining treatments are discussed. Advances that improve predictive value for neurological recovery are utilized in affirming and discussing the implications for end-of-life wishes of individuals in the setting of intensive resuscitative therapies.There is an irreducible amount of uncertainty in clinical decision-making. Both health care providers and patients experience anxiety elicited by clinical uncertainty, and this can lead to missed opportunities for healthy shared decision-making. In order to improve the patient-provider relationship and the ethical qualities of decision-making, the provider first needs to recognize where his/her "unknowing" exists. This article presents a model for a unique ethics of unknowing by identifying three levels at which the provider's knowledge or lack thereof impacts clinical decision-making. The model illuminates ethical choices that providers can make to promote healthy patient-provider relationships. The means by which an ethics of unknowing informs shared decision-making in patient care will be exemplified through a case study of one patient's encounters with several physicians while making difficult decisions throughout her breast cancer journey.This study explores how stories told at a United States Food and Drug Administration (FDA) public hearing justify a label change intended to reduce the prescribing of opioids to people with chronic noncancer pain (CNCP). Drawing on a social constructionist framework, which holds that narratives play an essential role in influencing public policy, I employ Loseke's method for the empirical analysis of formula stories to examine the institutional narratives told at the hearing. I find that the stories serve to construct moral boundaries around different groups of patients with pain. Patients with cancer and life-limiting illness are constructed as unquestionably deserving of treatment with opioids, while patients with CNCP are constructed as potential "addicts" needing protection from opioid-related harm. I argue that the stories serve as moral justification for the outcome of the hearing while simultaneously marginalizing the voices of CNCP patients who rely on opioids for pain relief.These narratives provide intimate descriptions of the challenges, frustrations, and sometimes, the satisfaction of caring for a family member with dementia. They are presented by twelve individuals who want us to understand and possibly learn from their lived experiences. At the beginning of their journey, most describe a slow awareness that "something is seriously wrong." During the middle stage, their narratives are filled with examples of conflict and frustration as the authors try to respond with patience to behavior that "makes no sense." Finally, most learn to forgive themselves and accept 'the new normal' of this person, or their death. For some, the end of their journey is filled with regret and guilt, while others find acceptance and peace. We are privileged to be immersed in these stories, as such honest descriptions are rarely shared with 'outsiders.'These stories convey the diversity of AD caregivers but also the similarities of the difficulties they experience over years of adjusting to the increasing challenges of the tasks. The authors vividly express both the toll caregiving takes; many also derive positive feelings from the experience. Among the bioethical issues raised in the stories are the failure of professionals to utilize caregivers' intimate knowledge of the person, the tension between lying to and comforting the person, choices at the end of life, and the still-emerging impact of genetic and biomarker information about the caregiver's own susceptibility to the disease. It is common for caregivers and professionals to characterize the relationship of caregiver and parent as "role reversal." This commentary calls for a new look at that framework, which fails to recognize the many differences between caregiving for a child and for a person with AD.This commentary focuses on 12 narratives written by caregivers of people living with Alzheimer's Disease and other types of dementia. While each narrative is distinctive and particular telling, common themes woven throughout the narratives include embarking on a journey; I changed and they changed; feelings elicited; the hardest and best parts; understandings and acceptance; intersections; and what the future holds. This commentary shares these common themes and how they play out in the lives of people caring for loved ones with dementia. The last section connects the narrative themes to bioethical inquiry, with a focus on discerning moral boundaries. The boundaries touched on relate to justice within families, caregiver self-respect, and the persistence of persons and personal relationships over time.This symposium includes twelve personal narratives from people who have provided care to a spouse, parent, another relative, or friend with Alzheimer disease or related dementias (ADRD). People with ADRDs often face years of cognitive decline with memory and thinking that eventually require help from others to assist with their daily activities. Most people caring for older adults in the US are unpaid family members, friends, or other informal caregivers. People providing care often experience emotional and physical stress, or financial burdens.  https://www.selleckchem.com/products/XL184.html  This symposium also includes three commentaries by experts in the fields of bioethics and philosophy, justice in healthcare, family caregiving, and end of life choices. These narratives provide a forum for exploring caregiver needs, suffering, benefits, and joys, as well as opportunities to improve the way we support caregivers and people with dementia and Alzheimer disease.