The AMA Journal of Ethics invites original submissions for peer review consideration on the following themes that will be explored in 2021 and 2022:
December 2021: Health Justice and Diversity in Medical School Admissions
During a 1966 Chicago assembly of the Medical Committee for Human Rights, Reverend Dr. Martin Luther King Jr. has been credited with stating, “We are concerned about the constant use of federal funds to support this most notorious expression of segregation. Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death.” Truth of this declaration echoes across decades to the present time. As Dr. King noted, health inequity has persisted, in our organizational policies and practices, along axes (race, ethnicity, and gender, for example) of socially and economically entrenched patterns of oppression. So, health inequity is not merely a product of the turn of fate’s wheel, not unfortunate, but unjust, and therefore, remediable over time.
Diversifying the work forces of health care is necessary, but not sufficient, for achieving health equity. One good start, however, has been to define what constitutes underrepresentation in, arguably, the most prestigious of the health professions: medicine. The Association of American Medical Colleges defines underrepresented in medicine in terms of “racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population.” Diversity motivates key clinical and professional educational goals, and this can be a source of common ground when conflict emerges about which kinds of diversity matter most and how applicants’ self-identifications as members of minoritized groups should be regarded when awarding scholarships and offering admission. Since different strategies vary in how effectively they motivate equity or retention among members of different groups in medicine, how influential these factors should be in admissions diversification strategies is hotly contested and worthy of investigation through an ethics lens.
The December 2021 issue of the AMA Journal of Ethics will investigate these strategies and questions. We invite manuscripts considering diversity as a priority in medical school admissions; the nature and scope of legal, ethical, cultural, and social stakes of these decisions at procedural and policy levels; and what should constitute just admissions criteria for achieving diverse class composition.
Manuscripts submitted for peer review consideration and inclusion in this issue must follow Instructions for Authors and be submitted by 29 January 2021.
January 2022: Disparities Along the Medical/Dental Divide
Dental and medical professionals tend to experience structural barriers to responding fully to patients’ needs because of differences in training, insurance coverage, and access to services. This issue of the AMA Journal of Ethics seeks wide-ranging perspectives on the nature, scope, and influence of the medical/dental divide, exemplary or scalable models of improved care coordination, and lessons from dental and medical care service delivery that can benefit all clinicians and motivate better outcomes for patients and communities.
Manuscripts submitted for peer review consideration and inclusion in this issue must follow Instructions for Authors and be submitted by 26 February 2021.
February 2022: Tactical Health and Law Enforcement
Tactical health involves providing field-based clinical support to law enforcement operations in frontline crisis interventions and prehospital emergency care. Health professional skill can inform individual officers’ occupational health maintenance and help agents of the state navigate primary and secondary trauma and post-trauma experiences in field-based and clinic-based settings. Tactical medicine and social work expertise can also inform department- and agency- level policies, decisions, and responses to community health and safety threats. Ethical questions considered in this issue focus on the nature and scope of health professionals’ collaborations with law enforcement personnel during and following critical event preparation and responses.
This issue of the AMA Journal of Ethics seeks wide-ranging perspectives on what the nature and scope of clinical expertise should be in emergency response systems engineering, whether and when in-field tactical clinicians should carry weapons, degrees of field environment austerity in which tactical clinicians should be prepared to provide support to law enforcement or care to ill or injured persons, how dual loyalty conflicts should be managed by tactical clinicians in detention or interrogation environments, how clinical expertise should inform real-time law enforcement de-escalation strategies, whether and when tactical clinical demands in the field should be prioritized according to needs of an individual ill or injured person or according to public health and community needs, and whether and to what extent tactical health goals should prioritize local, regional, national, or international interests.
Manuscripts submitted for peer review consideration and inclusion in this issue must follow Instructions for Authors and be submitted by 30 March 2021.
March 2022: Toward Abolition Medicine
Recent social movements calling for the abolition of key instruments of anti-black state violence, such as policing and incarceration, have initiated important conversations about roles of abolitionist standpoints in promoting individuals’ and communities' health. Medicine’s interfaces with hyper-punitive, deeply racialized approaches to state authority prompt this theme issue’s inquiry: What might abolitionist approachesto health care look like in health professions education, clinical care, and research?
Clinicians, public health experts, and bioethicists have key roles to play in mobilizing abolitionist discourses, equity strategies, and wide-ranging inquiry across the health sciences about eliminating anti-blackness in health professionalization, biomedical and public health research, and everyday caregiving and service delivery. Iwai, Khan, and DasGupta suggest, “The essential work of abolition medicine is to interrogate the upstream structures that enable downstream violence like police brutality, in addition to reimagining the work of medicine altogether as an anti-racist practice.” The March 2022 issue of the AMA Journal of Ethics welcomes manuscripts that motivate practical and conceptual advances from ;this launch; theorize possibilities about what should constitute abolitionist ideals; ;interrogate carceral logics that reify racial subordination; and help create spaces for imagining and developing abolitionist sensibilities that improve health experiences of people experiencing structural violence in business, research, policymaking, and all influence-wielding practices in American health care.
Manuscripts submitted for peer review consideration and inclusion in this issue must follow all Instructions for Authors and be submitted by 30 April 2021.
April 2022: Health Equity In US Latinx Communities
Latinx communities in the US include over 60 million people with a plurality of political beliefs, cultural practices, and wealth. This diversity is also expressed in population health data: some health indicators suggest advantages of Latinx community membership while other data are evidence of inequitable disease burden and maldistribution of environmental and occupational risk. Legacies of past colonial conquest of the Americas persist in discrimination and marginalization today and are embodied by members of our Latinx communities.
The April 2022 issue of the AMA Journal of Ethics welcomes explorations of clinicians’ and organizations’ roles and responsibilities in eliminating clinical practices, organizational policies, and other structural drivers of Latinx health inequity in the US. Manuscripts about innovation in Latinx health equity research and teaching resource development are welcome. The journal also welcomes contributions about the nature and scope of individual and collective responsibility today for racial and ethnic health inequity produced over generations of European conquest of Native Americans’ lands in North, Central, and South America; negative health impact of monolithic, oversimplified representations of culturally and linguistically complex communities and plurality in individual identities; relationships among political status, health status, and access to health services; and the paradox of longer life expectancy despite experiences of historically entrenched oppression among Latinx communities in the United States.
Manuscripts submitted for peer review consideration and inclusion in this issue must follow all Instructions for Authors and be submitted by 28 May 2021.
May 2022: Unregulated Supplements
Dietary supplements, such as oral vitamins, minerals, and herbals cannot be marketed with claims to prevent or treat disease. Yet, they are typically recommended, used, and expected to improve a person’s health. Unlike prescription and over-the-counter medications, dietary supplements are not approved by the Food and Drug Administration (FDA) for safety and efficacy. They are categorized by the FDA among many food products for which labeling about content and claims about purpose, safety, or efficacy are best regarded as marketing. This issue investigates why buyer and clinicians should not only beware of dietary supplements’ risks, but carefully consider their beliefs about roles these unregulated products play in forming expectations, planning care, and sustaining a 35-billion-dollar US market.
The FDA’s categorization of dietary supplements as outside the scope of its regulatory authority is neither clinically nor ethically neutral. Some uses of some of these products generate interactions with medications, which can exacerbate a person’s current health problems or cause new ones. Clinicians are often unaware dietary supplements’ actual ingredients or quality and are often unaware of which ones their patients take, which can complicate treatment planning and outcomes assessment. Roles of American household expenditures on products believed to help a person lose weight, build muscle, or improve sex, in particular, should be considered in light of overall health care spending, public health, and equity.
The May 2022 issue of the AMA Journal of Ethics considers these and other ethical, clinical, and legal implications of not federally regulating dietary supplements. We welcome manuscripts about challenges posed by the current FDA regulatory framework for dietary supplements, what clinicians should know about these products’ quality and safety, social and cultural factors that inform decisions to recommend or use dietary supplements, and roles of laboratory testing and physician-pharmacist collaborations in determining dietary supplements’ composition.
Manuscripts submitted for peer review consideration and inclusion in this issue must follow all Instructions for Authors and be submitted by 29 June 2021.
June 2022: Health Care in Conflict Zones
Protracted conflict requires health care systems, organizations, and professionals to try to manage clinical, ethical, and legal complexities of service delivery under austere conditions. Triage demands prioritizing most severely ill or wounded civilians and combatants prompt and creating policies and practices that seek to do good, or at least enough good, with few resources. Protecting clinicians and their capacities to respond to crises requires extraordinary moral imagination and adaptability.
The June 2022 issue of the AMA Journal of Ethics welcomes wide-ranging explorations about resources allocation during armed conflict; responding to conflict-affected civilians and combatants without being perceived as taking sides; navigating clinician-patient relationships when fighting is nearing health care sites; navigating patient access to care when transportation routes have been ambushed; or responding to expressions of disrespect for the bodies of dead, dying, or surviving patients. Perspectives on human subject research; whether and when to collaborate with governments, rebels, paramilitary groups, or nongovernmental organizations; and lessons from the field are welcome, too.
Manuscripts submitted for peer review consideration and inclusion in this issue must follow all Instructions for Authors and be submitted by 29 July 2021.
July 2022: Arts-Based Research in Health Care
Visual, musical, and poetic forms of creative expression have embodied healing in many cultures for millennia. Research methods based in these artistic forms have grown in prominence as the enterprise of health care has been led by kindred disciplines of bioethics and humanities to interrogate overmedicalization, to resist hyper focus on measurability when the cost is neglect of narratives and experiences, and to recognize tendencies that too often privilege outcomes over processes. What we’ve learned is that medicine has much to learn from and contribute to the arts, and that the arts have much to learn from and contribute to medicine.
Both artistic and clinical practices require professionals who value relationships and can skillfully draw from those relationships to collaboratively generate beauty or healing, perhaps humanity's greatest pursuits. Our best artists and clinicians express virtues of integrity, compassion, curiosity, and empathy and appreciate the possibility that some of the most poignant expressions of respect for others grow from sharing one’s own vulnerabilities and from sharing power. Reflexivity is required for both subject-artist, patient-clinician, and subject-investigator relationships to inform, evoke, enthuse, inspire, and maximize what can be learned from well-designed research protocols and partnerships. The July 2022 issue of the AMA Journal of Ethics welcomes wide ranging explorations of how arts-based approaches to investigation promote scientific rigor, generate evidence, communicate outcomes, and illuminate key ethical and aesthetic insights about what it means to care well and be cared for well.
Manuscripts submitted for peer review consideration and inclusion in this issue must follow all Instructions for Authors and be submitted by 29 August 2021.