AMA Journal of Ethics. August 2017
This month in Journal of Ethics
Iatrogenesis in Pediatrics
Despite best efforts to do no harm, clinicians should be prepared to respond to patients who experience adverse outcomes of even the best health care. Often thought to refer only to medical error, iatrogenesis characterizes a wider range of possible health care outcomes that are, as the Greek etymology suggests, physician generated. Iatrogenic consequences can be side effects from medications, surgical complications, traumatic stress from specific health care experiences, or failure to provide necessary care. Iatrogenic outcomes are particularly fraught in pediatrics, due to children’s inherent vulnerability as patients who typically lack decision-making authority. This month’s issue of the AMA Journal of Ethics grapples with neglected clinical and ethical questions about pediatric iatrogenesis, including how clinicians communicate iatrogenic risks to patients’ parents or guardians, how clinicians manage therapies with inevitable iatrogenic harms, and how clinicians might consider, respond to, and mitigate iatrogenic consequences of their practices.
Should Long-Term Consequences of NICU Care Be Discussed in Terms of Prognostic Uncertainty or Possible Harm? Commentary by Genevieve Allen and Naomi Laventhal, MD, MA Complications of caring for extreme prematurity should be discussed and decisons shared.
Should Clinicians Medicate against Structural Violence? Potential Iatrogenic Risks and the Need for Social Interventions Commentary by Lauren E. Hock, MD, and Niranjan S. Karnik, MD, PhD Risks of off-label medication to treat aggression should be balanced with consequences of not responding to social factors.
Are Physicians Blameworthy for Iatrogenic Harm Resulting from Unnecessary Genital Surgeries? Samuel Reis-Dennis, PhD, and Elizabeth Reis, PhD Physicians are accountable to patients for physical and psychological harm caused by intersex surgery, cosmetic vaginal surgery, or circumcision.
Performing Pain and Inflammation: Rendering the Invisible Visible Artwork and captions by Arseli Dokumaci, PhD Three images explore an artist’s experience of living with rheumatoid arthritis.
September Incarceration and Correctional Health Care
October Clean Water Access and the Roles of Clinicians
November Ethics of Collaborative Health Systems Design
December Health Care Ethics and Professionalism in the Era of Climate Change
January Clinicians’ Responsiveness to Violence
February Roles of Comics in Health Care Ethics
© 2017 American Medical Association. All Rights Reserved. ISSN 2376-6980