Editors' Note

Shortly after the March 2020 COVID-19 stay-at-home orders, the Bioethics Research Center (BRC) at Washington University, directed by NIB co-editor James DuBois, submitted a grant proposal for a project "Innovative Medicine and Research on COVID-19: Addressing Potential Ethical, Oversight, and Regulatory Barriers." The project was supported by the NIH, National Institute on Aging (NIA) [3R01AG058254–03S1] and aimed to conduct an online survey with IRB professionals or researchers who review, propose, or conduct research on COVID-19. The goal was to better understand the ethical, oversight, and regulatory barriers of doing COVID-related research during the pandemic. The survey included a question that asked participants if they would be willing to share more about their experience in a narrative published in NIB. The symposium editors invited authors to share their experiences in this double issue of NIB, comprised of personal stories from 12 IRB professionals and 12 COVID-19 researchers. An additional 4 narratives from IRB professionals and 5 from researchers are included in the online supplement. The narratives offer lessons on how regulations and institutional policies and practices can be modified to accommodate the needs of researchers and society during pandemics. The narratives also serve as an historical account of research and research oversight during this unique and extraordinary time.

Ana Iltis and Gianna McMillan served as the narrative symposium editors. The two, along with the editorial office, wrote a call for stories that was sent to researchers and IRB professionals along with an invitation to write and share their stories. Gianna McMillan, Jerry Menikoff, and Sumit Mohan contributed commentaries on the IRB professionals' narratives, while Ana Iltis, Bruce Gordon, and J. Wilson Jackson provided commentary on the researcher narratives. The commentary authors offer their perspectives on the narratives through the lens of their expertise in research ethics, health law and policy, medical research, and patient and research subject advocacy.

"Asking the simple question 'What does love require of me?' when faced with a difficult decision might open up ways of thinking and acting that otherwise may not have come to mind." Sams et al. contributed the research article in this issue of NIB, "The Secret of Quality Is Love: A Qualitative Study Exploring Physician and Nurse Perspectives on What It Means to Love Their Patients." The authors hypothesized that "there is a language of love relevant to health care, which can inform its practice and shape future healthcare professionals." The authors conducted in-depth interviews with 29 physicians and 32 nurses to explore their perspectives on what it means to love their patients. Participants expressed specific hallmarks and virtues that they believe characterize loving physicians and nurses. Practical examples include providing excellent care, advocating for patients, ensuring patients are comfortable, and listening to patients. The majority of participants contended that loving their patients may be the secret to providing high-quality health care.

This issue of NIB includes two case studies. The first, "The Ethics of Choosing a Surrogate Decision Maker When Equal-Priority Surrogates Disagree" is from our case study partnership with the UCLA Health Ethics Center. The author, Matthew Shea, discusses how to proceed when surrogate decision makers of equal priority disagree—a relatively common dilemma on which there is no ethical consensus. In this case, an elderly female had suffered a stroke and was not capable of medical decision making. Her four adult children disagreed on whether to continue aggressive treatments or transition her to comfort care and allow her to die. Three of the children favored comfort care, while one argued for continued treatment. Shea proposes three methods for choosing a surrogate in cases of disagreement.

The second case study in this issue "A Gay Epidemiologist and the DC Commission of Public Health AIDS Advisory Committee," by Steven Coughlin, Paul Mann and Bruce Jennings is based upon lead author, epidemiologist Steven Coughlin's experience on an AIDS Advisory Committee in DC in the 1990s. Coughlin served on the committee at a time when AIDS was also a common and tragic theme in his private life and social circle. In creating and distributing educational materials...