Call for Papers
The AMA Journal of Ethics invites original submissions for peer review on the following themes that will be explored in 2017-2018 issues
▼September Incarceration and Correctional Health Care
The United States incarcerates a greater share of its population than any nation on earth, including disproportionate numbers of people from minority communities. Patients who experience incarceration have poorer health outcomes and shorter life expectancy. Clinicians in correctional settings, in particular, are uniquely challenged when trying to offer good care while respecting patients’ autonomy. The September 2017 issue of the AMA Journal of Ethics will explore the impact of incarceration on the health system, professionals, and patients.
▼October Clean Water Access and the Roles of Clinician
Ongoing since 2014, the Flint, Michigan drinking water crisis was declared a federal emergency after a local pediatrician publicized her patients’ blood lead levels. This public health emergency illuminates questions about the nature and scope of clinicians’ obligations to identify, assess, and respond to risks to patients’ and communities’ health from harmful microbial and chemical levels in drinking water. Clinicians should be trained to recognize symptoms of contaminated water consumption, but how should they be trained to help prevent contamination and execute other public health duties? The October 2017 issue of the AMA Journal of Ethics will explore these duties as well as clinicians’ roles in defining and enforcing the parameters of what constitutes clean water and in addressing barriers to clean water access in the United States.
▼November Ethics of Collaborative Health Systems Design
Co-creation refers to interactive practices that help critical stakeholders—patients, clinicians, and administrators, for example—work together to discern mutual values, develop strategies to address shared challenges, promote common goals, and motivate desired outcomes. Popularized in the 1990s as a means of improving consumer satisfaction, co-creation efforts began by inviting consumer participation in designing, marketing, and delivering products and services. In the health care sector, co-creation seeks to maximize health systems performance, support efficiency in cross-disciplinary collaboration among clinicians, and personalize patients’ health care experiences. The November 2017 issue of the AMA Journal of Ethics considers ethical dimensions of what it means to implement and operationalize this kind of strategic planning in health care, both at the micro level of patient-clinician relationships, for example, and at the macro level among providers, payers, and policy-makers.
▼December Health Care Ethics and Professionalism in the Era of Climate Change
“Climate change is the greatest threat to global health in the 21st century” is the World Health Organization’s web-based dispatch for immediate action. WHO Director-General Dr. Margaret Chan adds, “The evidence is overwhelming: climate change endangers human health. Solutions exist and we need to act decisively to change this trajectory." Expected consequences include the spread of disease, drought, and more extreme weather events. Despite the gravity and relevance to health of these phenomena, the roles of health care professionals in responding and the roles of organizations and governments in establishing policies and implementing action plans have been neither clarified, nor, by some, even considered. The December 2017 issue of the AMA Journal of Ethics will explore clinical and ethical questions about domestic and global health impact of climate change, and the nature and scope of clinicians’, organizations’, and governments’ obligations to address them.
▼January Clinicians’ Responsiveness to Violence
Individuals suffering some form of violence routinely seek health care. As first responders, clinicians are required to tend these patients equitably and promote their best interests. At the level of clinical practice, guidelines can help or hinder clinicians’ capacities to fulfill these duties to patients who are victims of gun violence or rape, for example. Standards of care regarding sexual assault protocols and forensic examinations, for example, also have important limitations that also need clinical and ethical consideration. At the macro level, clinicians can work with organizations and governments to implement prevention strategies. The January 2018 issue of the AMA Journal of Ethics will explore the nature and scope of clinicians’ obligations to respond to violence clinically and as a public health threat.
▼February Roles of Comics in Health Care Ethics
The arts have long been used as cultivars of reflection and storytelling about health and health care. Like novels, short stories, painting, sculpture, and film, comics can convey poignant stories, deliver analytical depth, and offer interpretive alternatives to text-based ethical inquiry. The February 2018 issue of the AMA Journal of Ethics will explore comics’ power to visually represent and comment on health care and health care experiences, guide patients’ and clinicians’ learning, and approach consideration of values in health care not only ethically, but aesthetically.
▼March Global Reproductive Health Ethics in the 21st Century
Reproductive technology and inequalities in health status and access to reproductive health care services have consistently been critical areas of inquiry in bioethics. Questions persist about access and utility of reproductive technologies, differential treatment on the basis of gender, the roles of resource-rich clinical education and training programs among resource-poor and diverse patient populations, and the changing nature of national and international reproductive health law and policy. The March 2018 issue of the AMA Journal of Ethics will explore the ethical, social, and cultural stakes of reproductive health care as a global clinical and educational enterprise.
▼April Ethical Considerations in Plastic and Reconstructive Surgery
Plastic and reconstructive surgeons care for a variety of patients, including those with recent trauma, chronic wounds, and craniofacial anomalies. Clinical and ethical questions in plastic and reconstructive surgery routinely involve informed consent and risk disclosure prior to procedures and weigh values such as cosmesis and functioning in decisions with patients. The April 2018 issue of the AMA Journal of Ethics will explore these and other questions that consider these surgeons’ potential conflicts of interests in commercial self-promotion and advertising, the roles of some in endorsing aesthetic norms that can be harmful to patients, and the standards according to which plastic and reconstructive surgeons should be trained.
▼May Trauma Surgery Ethics
Trauma changes a life forever. Trauma professionals’ decisions can too. High-stakes clinical decisions—whether to give blood, go to the operating room, amputate or try to salvage a mangled extremity—are often made quickly and without knowledge of a patient’s name, age, or history. Such decisions are also almost always made without knowledge of a patient’s goals, values, or advanced directives. Not always, but commonly and of necessity, action must outpace deliberation. The May 2018 issue of the AMA Journal of Ethics will explore the ethics of urgent decision making in trauma care settings, what it means for clinicians to approach these kinds of decisions responsibly, and what it means for patients and their loved ones to have the aftermaths of those decisions communicated with clarity and compassion. This issue will also explore what trauma care policies can mean for public health, community planning, and resource allocation.
▼June Ethics in Burn Care
Burn injuries present numerous clinical and ethical complexities for caregivers and patients. Discourse on ethical decision making in burn care tends to focus on a few topics, such as end of life practices and how to regard consent, refusal, and other expressions of autonomy following Dax Cowart’s case in 1973. The June 2018 issue of the AMA Journal of Ethics will revisit these issues with new perspectives and also explore ethical questions including but not limited to bias expression in burn care settings, pain management, surgical education practices, the nature and scope of clinicians roles in burn prevention, whether and when live donor grafts are appropriate, and how to weigh values such as survival, function, and cosmesis.
▼July Religion and Spirituality in Health Care Practice
Religion’s influence on patient care in hospital, clinic, hospice and other settings can be seen in requests for partnership in prayer, clinician-chaplain collaborations, and through organizations’ religious accommodations for patients and staff. Whether and how religion and spirituality training are critical components of students’ and clinicians’ development of cultural humility is one important set of questions that will be explored in the July 2018 issue of the AMA Journal of Ethics. At the macro level, too, this issue will consider faith traditions’ influence on health policy in organizations and governments.
▼August Ethics, Policy, and the Roles of Physicians in Care of the Dying
Quality of care for dying patients varies according to a number of factors, including diagnosis, prognosis, care setting and culture, and the adequacy of clinicians’ training in addressing patients’ needs at the end of life. While physician-assisted death, euthanasia, and the ethics of suicide have received copious attention in health professions discourse, what the roles of clinicians and patients should be in defining what actually constitutes dying and good care of dying people has received less attention. Which, if any, components of dying should be medicalized and why? What do patients and clinicians need to know about dying? The August 2018 issue of the AMA Journal of Ethics will explore these questions and other critical ethical, social, cultural, and political factors shaping clinicians’ roles and capacities to care well for dying patients.
▼September Ethics in Precision Health
Precision medicine aims to use a variety of data sources, including genomics and electronic health records, to concentrate therapeutic intervention on those patients who will benefit, thus striving to improve quality and value of medical care. Precision health broadens this approach by incorporating disease prevention and earlier diagnosis. To what extent are precision approaches new and what are clinical and ethical implications of these approaches for distinguishing between care and research? The September 2018 issue of the AMA Journal of Ethics will explore four major classes of issues: (1) consent, governance, and the appropriate use and disclosure of patient data; (2) ethical questions surrounding novel clinical applications of these approaches; (3) public policy questions about how to best fund, create, maintain, and secure databases of huge numbers of patients’ information; and (4) questions about how to justly distribute these efforts’ risks and benefits.
©2017 American Medical Association. All Rights Reserved. ISSN 2376-6980