Nicole Martinez-Martin, JD, PhD, Laura B. Dunn, MD, and Laura Weiss Roberts, MD, MA
Calibrating a machine learning model with data from a local setting is key to predicting psychosis outcomes. Clinicians also need to understand an algorithm’s limitations and disclose clinically and ethically relevant information to patients.
AMA J Ethics. 2018;20(9):E804-811. doi:
10.1001/amajethics.2018.804.
Targeted dosing to treat pediatric inflammatory bowel disease is challenging because dosing guidelines are based on data gathered from adult subjects of clinical trials. Patients’ families and health care organizations also incur high costs and must try to balance potential benefits against risks of ongoing monitoring.
AMA J Ethics. 2018;20(9):E841-848. doi:
10.1001/amajethics.2018.841.
Transitions in relabeling personalized medicine as precision medicine, precision health, or wellness genomics reflect shifting the locus of responsibility for health from individuals to clinicians and in shifting focus from genetic risk to genetic enhancement.
AMA J Ethics. 2018;20(9):E881-890. doi:
10.1001/amajethics.2018.881.
Clara C. Hildebrandt, MD and Jonathan M. Marron, MD, MPH
Gene editing with CRISPR/Cas9 raises concerns about equitable access to therapies that could limit research participation by minority group members. These concerns can be addressed through public education, transparency, and stakeholder partnerships.
AMA J Ethics. 2018;20(9):E826-833. doi:
10.1001/amajethics.2018.826.
Cynthia E. Schairer, PhD, Caryn Kseniya Rubanovich, MS, and Cinnamon S. Bloss, PhD
Questions about data privacy need to be addressed when research institutions negotiate with companies developing mobile health applications. Commercial terms of use and data sharing notifications should be reviewed before use in human subject research settings.
AMA J Ethics. 2018;20(9):E864-872. doi:
10.1001/amajethics.2018.864.
Graphic pathographies can illustrate how overreliance on statistics can obscure the clinical relevance of patients’ experiences of anxiety when they’re presented with prognoses.
AMA J Ethics. 2018;20(9):E897-901. doi:
10.1001/amajethics.2018.897.
This image depicts a dying elder undergoing cardiopulmonary resuscitation, suggesting consideration of the ethical weight of the invasiveness and force of chest compressions.
AMA J Ethics. 2018;20(8):E774-775. doi:
10.1001/amajethics.2018.774.
Tracy Shamas, MSN, APRN and Sarah Gillespie-Heyman, MSN, APRN
Veterans at the end of life have special needs due to posttraumatic stress disorder, environmental exposures, and the influence of military culture on their values. Those who die outside the Veterans Affairs health care system, however, can be at increased risk for receiving outpatient palliative care that is not sensitive to these factors.
AMA J Ethics. 2018;20(8):E787-792. doi:
10.1001/amajethics.2018.787.
Physicians new to a case might object to an established care plan. Practice variation, clinical momentum, and how value is assigned by different parties to acute care and comfort measures can each contribute to conflict in these cases.
AMA J Ethics. 2018;20(8):E699-707. doi:
10.1001/amajethics.2018.699.