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Review
. 2025 Aug 26.
doi: 10.1038/s41372-025-02403-0. Online ahead of print.

Ethical considerations in quality improvement

Stephen A Pearlman  1   2 , Peter D Murray  3 , Roopali Bapat  4   5
Affiliations
Review

Ethical considerations in quality improvement

Stephen A Pearlman et al. J Perinatol. .

Abstract

Clinicians have an ethical responsibility to improve care while safeguarding patients from harm. This ethical imperative drives the implementation of Quality Improvement (QI) initiatives aimed at enhancing patient outcomes. In comparison to human subjects' research, QI efforts may have different ethical considerations that seem less well defined. This article explores the ethical complexities in neonatal and perinatal QI work associated with designing, conducting, and disseminating QI projects. QI efforts should be grounded in ethical tenets such as beneficence, non-maleficence, justice, and respect for autonomy particularly when applied to vulnerable populations such as neonates. By recognizing the ethical considerations unique to QI, investigators can promote transparency and context-aware practices, thereby improving the rigor, reproducibility, and safety of their initiatives. Thoughtful design and implementation can ensure that QI efforts are both ethically sound and clinically impactful, enhancing their trustworthiness and applicability across diverse clinical settings. CLINICAL TRIAL REGISTRATION (IF ANY): None.

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Conflict of interest statement

Competing interests: The authors have no competing interests to declare. SAP, PDM, and RB each conceptualized the manuscript, wrote portions of the manuscript, and edited the manuscript.

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