The AMA Journal of Ethics invites original submissions for peer review consideration on the following themes that will be explored in 2019:
October 2019: Insights on Value and Values from Decision Science for Clinical Ethics
In situations in which uncertainty exists about whether one care option is better than another, patients’ and clinicians’ personal values can color their perceptions of "objective" clinical and economic value. These values tend to be influential in assessing the value of particular procedures, so interventions that help clinicians and patients reveal and assess them is clinically and ethically important. For example, interventions designed to help clinicians draw out and draw upon patients’ assessments of value can help improve health care quality, reduce costs, and facilitate refusal of care that patients perceive as having little value. But, what constitutes good empirical evidence of how patients’ and clinicians’ conceptions of clinical and economic value inform their decision making? How should evidentiary standards of value assessment be used in clinical ethics consultation? This issue of the AMA Journal of Ethics explores these ethical questions about decision science—the development of methods for learning how people make decisions under conditions of uncertainty—and also considers legal, social, cultural dimensions of applying decision science to actual decision making in ethically complex cases in health care settings.
Manuscripts submitted for peer review consideration and inclusion in this issue must follow all Instructions for Authors and be submitted by 1 February 2019.
November 2019: Ethics of Assessing Quality of Life in Reconstructive Transplantation
Quality of Life (QoL) assessments have roles in a wide range of ethical discussions about end-of-life care, transplantation, health care services' effectiveness and efficacy, and specifying what consitutes "essential health care services." In clinical contexts, how we assign value to QoL can lead to conflicts among patients, surrogate decision makers, and clinicians. In policy contexts, QoL judgments sometimes suggest disagreements about what the facts are and what they mean. In some cases, QoL is the primary reason for undertaking particular clinical interventions. This is true of new types of transplantation, known as reconstructive transplants or vascularized composite allotransplants (VCA), including transplants of the hand, face, penis, larynx, and uterus, which are primarily conducted because of how they can influence a patient's QoL. Yet, ethical inquiry into QoL aspects of VCA is lacking, particularly when engaging topics such as patients' lived outcomes, the impact of social acceptance or stigma on patients' experiences of physical disfigurement or functioning, and the effects of disparate access to personal and financial support on a person's candidacy for VCA. We invite manuscripts examining these and other ideas central to empirical investigations and approaches to health care ethics and policy in the area of VCA.
Manuscripts submitted for peer-review consideration and inclusion in this issue must follow all Instructions for Authors and be submitted by 1 March 2019.