AMA Journal of Ethics®

Illuminating the art of medicine

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AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. May 2014, Volume 16, Number 5: 325-415.

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May 2014 Contents

Ethical Issues in Geriatric Care

Ethics Poll

Do you have an advance directive or have you appointed someone to make medical decisions for you if you become unable to do so?
Yes.
No.

Do you think a person's age is an acceptable basis for determining whether he or she can receive a scarce (e.g., human organ) resource or expensive (e.g., hip replacement) intervention?
Yes.
No.
Don‘t know.

Advance directives are legal instruments that document a person’s wishes about life-sustaining treatment (living will), choice of a surrogate decision maker in case the person is no longer able to make decisions (durable power of attorney for health care), or both. Which of the following do you think is the main reason why advance directives do not always provide the end-of-life decision-making guidance they were intended to provide?
People don’t want to think about being unable to make decisions for themselves, so they either don’t execute an advance directive, or they do it poorly.
Most people would rather leave treatment decisions to physicians.
Most people lack confidence that a family member or other surrogate could make the decision the he or she would make if able to decide.
People prepare advance directives at one point in life and their situation changes so much that the advance directive doesn’t offer guidance.
Physicians and hospitals disregard advance directives because they are afraid of being sued if they withhold any treatment from a patient.
Appointed surrogate decision makers are reluctant to accept the burden of making life-or-death decisions for someone else.
All of the above.
None of the above.

Read two ethical commentaries about advance directives in the May issue of Virtual Mentor.

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From the Editor

Medicine's New Breed of Patients
Amirala Pasha
Full Text | PDF
Virtual Mentor. 2014; 16:327-329.

Educating for Professionalism

Ethics Cases

What Is the Physician’s Responsibility to a Patient’s Family Caregiver?
Commentary by David Barnard and Mark J. Yaffe
Full Text | PDF
Virtual Mentor. 2014; 16:330-338.

Should Age Be a Basis for Rationing Health Care?
Commentary by Haavi Morreim, Ryan M. Antiel, David G. Zacharias, and Daniel E. Hall
Full Text | PDF
Virtual Mentor. 2014; 16:339-347.

Questions about an Advance Directive
Commentary by Bernard J. Hammes, Thomas D. Harter, Meera Balasubramaniam, and Yesne Alici
Full Text | PDF
Virtual Mentor. 2014; 16:348-356.

The Code Says

The AMA Code of Medical Ethics’ Opinions on End-of-Life Decision Making
Full Text | PDF
Virtual Mentor. 2014; 16:357-358.

Law, Policy, and Society

Health Law

Statutes to Combat Elder Abuse in Nursing Homes
Richard Weinmeyer
Full Text | PDF
Virtual Mentor. 2014; 16:359-364.

Policy Forum

The Exclusion of Older People from Participation in Cardiovascular Trials
Jerry H. Gurwitz
Full Text | PDF
Virtual Mentor. 2014; 16:365-368.

Medicare and Means-Based Fees
Richard G. Stefanacci
Full Text | PDF
Virtual Mentor. 2014; 16:369-372.

Medicine and Society

Who’s Responsible for Granny?
Carol Levine
Full Text | PDF
Virtual Mentor. 2014; 16:373-379.

Baby Boomers’ Expectations of Health and Medicine
Eva Kahana and Boaz Kahana
Full Text | PDF
Virtual Mentor. 2014; 16:380-384.

History, Art, and Narrative

History of Medicine

Geriatric Medicine: History of a Young Specialty
Mary Ann Forciea
Full Text | PDF
Virtual Mentor. 2014; 16:385-389.

Op-Ed and Correspondence

Op-Ed

Against a Duty To Die
Nancy S. Jecker
Full Text | PDF
Virtual Mentor. 2014; 16:390-394.

Resources

Suggested Readings and Resources
PDF
Virtual Mentor. 2014; 16:395-411.

About the Contributors
Full Text | PDF
Virtual Mentor. 2014; 16:412-415.