The AMA Journal of Ethics invites original submissions for peer review consideration on the following themes that will be explored in 2023 and 2024:
April 2023: Meat and Health
As meat production and consumption increases globally, so do incidence of diet-related illnesses, such as coronary artery disease and obesity. Some meat industry practices undermine public and environmental health, both of which clinicians, health professions, health care organizations, and governments are duty-bound to promote. This issue considers the nature and scope of these groups’ obligations to mitigate negative influences of nonhuman animal production and consumption on health in individual, community, domestic, and international spheres.
We welcome manuscripts for the April 2023 issue of the AMA Journal of Ethics® on ethics and health policy dimensions of meat production and consumption, including clinicians’ responsibilities as thought leaders in the clinical management of harms incurred by nonhuman animal production and consumption; health, social, environmental, and cultural consequences of plant-based meat substitutes; stewardship and roles of nonhuman animals in human food chains and human character; norms about expressing respect for meat-based dietary preferences, culinary practices, and traditions; whether and to what extent human production and consumption of nonhuman animals as food is ethically distinct from human production and consumption of nonhuman animals in biomedical or behavioral research; and how we should consider the nature and scope of dietary freedom in light of meat industrial psychology and marketing influences on choice architecture in the food supply.
Manuscripts submitted for peer review consideration and inclusion in this issue must follow Instructions for Authors and be submitted by 28 May 2022.
May 2023: IPE and Innovation
Interprofessional Education (IPE) began as a health and social care movement in the early 1970s and took firm hold in US-based accreditation standards in the mid-2000s. Since formation of the Interprofessional Education Collaborative®, IPE has become a “buzz word” trend and has gained momentum promoting patient-centered, collaborative care that reduces iatrogenic harm and improves health outcomes. IPE should start early in health professions education and prepare clinicians affectively for cross-disciplinary approaches to education and work culture that nourishes quality, collegiality, and safety in a rapidly evolving health sector.
This issue of the AMA Journal of Ethics® takes as its starting point that experimentation has long been a hallmark of IPE. This issue looks to illuminate interesting, important, complex, and neglected intersections of health professions curricular goals. We welcome broad-ranging classroom-, clinic-, and field-based explorations of IPE across clinical, human services, and legal domains, including environments traditionally viewed as non clinical, but in which clinicians’ expertise is key to day-to-day operations (ie, schools or drug treatment, mental health, or veterans courts) and students’, defendants’, and patients’ well-being and quality of life. We seek manuscripts that advance health professions, bioethics, and health humanities education and research about which criteria should be used to define IPE innovation. Content interrogating what it means for IPE to productively influence (1) professional identity formation; (2) skill development, communication, and team-based care; (3) diagnostic openness and clinical and cultural humility; (4) and health equity will be prioritized for inclusion in this issue.
Manuscripts submitted for peer review consideration and inclusion in this issue must follow Instructions for Authors and be submitted by 30 June 2022.
June 2023: Patient-Centered Transgender Surgical Care
The November 2016 issue of the journal, Transgender Health, focused on the importance of expanding gender-affirming health care services, enhancing quality of transgender patients’ clinical encounters, and improving general medical and mental health outcomes among patients with non-binary gender identities. This issue follows up on that initial inquiry, delving specifically into relationships among autonomy protections and patient-centered informed consent processes in gender-affirming surgical practice.
For this June 2023 issue of the AMA Journal of Ethics® we welcome manuscripts on a wide range of topics on this set of themes, developing patient-reported outcome metrics, patient perspectives on how a “gender dysphoria” diagnosis facilitate or undermines their pursuits of self-affirming gender expressions, how care teams should work with transgender patients to manage hormone-related comorbidities during surgical care and recovery, and more.
Manuscripts submitted for peer review consideration and inclusion in this issue must follow Instructions for Authors and be submitted by 28 July 2022.
July 2023: How We Over Rely on BMI
Patients who are fat or perceived as fat are commonly characterized by many clinicians as unreliable narrators of their own health histories, and negative bias can undermine diagnoses, intervention decisions, and even what some clinicians think fat patients deserve. Fat is widely considered a clinical threat and obesity is a descriptor applied to patients with BMIs at or over 30. While weight and BMI can be helpful clinical indicators, many of its applications are overvalued, imprecise, contested, and can incur substantial iatrogenic harm. This theme issue examines clinical and ethical shortcomings of medicine’s current approach to fat.
We invite manuscripts for the July 2023 issue of the AMA Journal of Ethics® that consider wide-ranging perspectives on interrogating BMI uses in fat persons’ marginalization as a source of iatrogenic harm and other kindred topics of clinical, ethical, social, and cultural importance.
Manuscripts submitted for peer review consideration and inclusion in this issue must follow Instructions for Authors and be submitted by 30 August 2022.
August 2023: Robotic Surgery Ethics
Robotic assisted minimally invasive surgical procedures have become increasingly common since FDA approval in 2000. First integrated into urologic care, robots now assist general, gynecologic, cardiothoracic, colorectal, pediatric, and head and neck operations. Indications for and applications of robotic surgical technology will continue to evolve, as will ethical questions robotics generates in areas such as informed consent, managing sources of risk and bias in training and credentialing surgeons to use robotics, and mitigating financial conflicts of interest at the intersection of macro-level organizational investment and surgical technique selection and decision-making. This theme issue looks to motivate conversation about clinical, ethical, and equity standards in a rapidly evolving robotic surgical frontier.
We welcome manuscripts that equip us well to motivate new inquiry grounded in ethics, art, policy, economics, risk management, history, society and culture, and surgical education innovation. Manuscripts submitted for peer review consideration and inclusion in this issue must follow Instructions for Authors and be submitted by 30 September 2022.
September 2023: Palliative Psychiatry
All general medical, surgical, and psychiatric patients deserve palliative approaches to their care. Palliative psychiatry, especially, deserves clinical and ethical attention because of its promise as an emerging field to renew attention to patients whose illnesses, such as treatment resistant depression, and symptoms, such as persistent suicidality, challenge our faith in health care as a life-affirming source of hope. Responding with care to the needs of these patients requires prioritization of symptom management, relief of suffering, quality of life, reduction of harm from aggressive interventions, and minimization of physical and chemical force. This theme issue investigates how inquiry into palliative psychiatry — at the patient, health system, societal, and policy level —reinvigorates core philosophy of medicine investigations into what health care is for.
We invite manuscripts for the September 2023 issue of the AMA Journal of Ethics® that consider the ethical, social, and cultural dimensions of palliative psychiatry. Papers exploring treatment resistance, remission, and prognosis in psychiatry; the palliative nature of many existing psychiatric interventions; psychiatric polypharmacy; and pluralistic approaches to psychiatry are welcome. Manuscripts submitted for peer review consideration and inclusion in this issue must follow Instructions for Authors and be submitted by 30 October 2022.
October 2023: Geriatric Psychiatry
Twenty percent of the US population is expected to be 65 years of age or older by 2030. Agism’s pervasiveness in US culture means it is also pervasive in health care and a cause of inequity that profoundly undermines elders’ quality of life. Independence and autonomy losses tend to accompany aging for all of us. Elders are vulnerable to exploitation and are exposed to late-life stressors that affect their mental health, accompany compromise or loss of independence and autonomy, and tend to track declines in general health and cognitive function. This theme issue also investigates reasons why diminishing numbers of geriatric mental health clinicians should draw clinical, ethical, and legal attention to whether US health care and its workforce is prepared to deliver the volume and quality of care elders deserve.
We invite manuscripts for the October 2023 issue of the AMA Journal of Ethics® that discuss topics in geriatric psychiatry on ethical and humane mental health care of older adults. Manuscripts submitted for peer review consideration and inclusion in this issue must follow Instructions for Authors and be submitted by 30 November 2022.
November 2023: Health and Loneliness
Human experiences of loneliness come from perceived deficits in social interaction. Loneliness first became a health concern due to its associated with increased mortality and functional decline, especially among elders. However, its increasing prevalence across age groups in the US calls for our health care system to pay clinical and ethical attention to loneliness as a common experience in American life and to position itself to respond with care. This theme issue considers loneliness as a key source of health vulnerability that remains underappreciated and provides insights as to how our health care system can more effectively care for patients with limited social networks.
We invite manuscripts for the November 2023 issue of the AMA Journal of Ethics® that critically consider the social, cultural, and ethical dimensions of loneliness as a specific kind of health vulnerability. We especially encourage submissions that examine the complexity of loneliness through an intersectional, cross-disciplinary lens. Manuscripts submitted for peer review consideration and inclusion in this issue must follow Instructions for Authors and be submitted by 20 December 2022.
December 2023: Belonging, Placement, and Turfing
The language of “placement” is key in health care organizations’ admissions and discharge planning policies and practices. Where patients are thought to belong has substantial clinical and ethical heft in the everyday operations of the US health services sector. Turfing is generally regarded as an inappropriate reference to patients whose needs and vulnerabilities prompt us to want to make them someone else’s responsibility. Turfing happens in inpatient settings when one care team looks to divert responsibility for a patient’s care to another team, in outpatient settings when clinicians refuse to take care of, say, Medicare or Medicaid patients, and in discharge planning to rehabilitation or skilled care facilities. This theme issue investigates clinical and ethical criteria for determining which specialists or generalists must care for a patient and for how long and considers what it means to be a person who belongs somewhere in health care.
We invite manuscripts for the December 2023 issue of the AMA Journal of Ethics® that consider clinical, ethical, social, cultural, and legal implications of patient belonging, placement, and turfing. Manuscripts submitted for peer review consideration and inclusion in this issue must follow Instructions for Authors and be submitted by 29 January 2023.
January 2024: Critical Pedagogy in the Health Professions
Health professional training is mainly competency-driven, with students’ learning and technical and affective skill development regularly assessed, usually in terms of standardized outcomes. Yet, competency-based medical education, in particular, seems to be more aspirational than real. For example, in a 10-school pilot study sponsored by the Association of American Medical Colleges, some schools' curricula meaningfully motivated only 1-2 competencies and not many could consistently map specific learning objectives to graduation competencies or assess them reliably. Addressing social privilege and motivating equity is particularly challenging. Some educators view coming to terms with privilege as teachable and assessable in competency-based frameworks, but others argue those frameworks exclude key perspectives.
Competency-based curricular design motivates licensure and credentialing ends that are essential to professional maturation and practice preparedness. But overreliance on competency-based teaching and learning has come under scrutiny by clinicians and educators for its inability to cultivate self-awareness about wielding professional authority, power, and privilege to promote well-being equitably. This issue considers how critical pedagogy—and its focus on interrogating patterns of marginalization, exploitation, and oppression to promote justice—can be operationalized in academic structures of health care.
We welcome broad-ranging classroom-, clinic-, and field-based explorations of critical pedagogical approaches to health professions, bioethics, and health humanities education and research. Content interrogating what it means for critical pedagogical approaches to productively influence (1) professional identity formation; (2) skill development, communication, and team-based care; (3) diagnostic openness and clinical and cultural humility; (4) and health equity will be prioritized for inclusion in this issue.
Manuscripts submitted for peer review consideration and inclusion in this issue must follow Instructions for Authors and be submitted by 28 February 2023.
February 2024: Health Ecology and Disease Transmission
Human-nonhuman animal disease transmission expresses complex intersections among human and domestic, agricultural, and wildlife animal communities and approximately 75% of emerging infectious diseases are now zoonotic, with continued climate change expected to exacerbate fraught linkages between all environments animals and plants share. One Health is an approach promoting national and international collaboratives, coordinated responses to human population growth, agricultural encroachment and deforestation, ecosystem disruption, and interactions that intensify transmission risk between more highly concentrated human and nonhuman animal reservoirs, human-nonhuman animal contact opportunities, and novel or evolving microbes. Climate change diminishes biodiversity; diminished biodiversity undermines natural ecological balance dynamics between pathogens and hosts and has already influenced health care dramatically. This theme issue investigates the nature and scope of our ethical, social, and cultural responses to these key changes.
We invite manuscripts for the February 2024 issue of the AMA Journal of Ethics® that consider ethically relevant features of human-nonhuman animal disease transmission in ecological context. Manuscripts submitted for peer review consideration and inclusion in this issue must follow Instructions for Authors and be submitted by 29 March 2023.
March 2024: Environmental Architecture of Psychiatric Inpatient Safety
When modern inpatient psychiatric units look to reduce patients’ risk of harm to self or others by modifying the environment and limiting patients’ access to personal items, patients’ comfort can be compromised. This should prompt us to carefully consider when patients’ experiences of their care environments undermine the therapeutic purposes of their hospitalization. This theme issue investigates criteria we use for assessing and evaluating patients’ risk of harm to self or others and which values should guide which iatrogenic harm risks we accept in their stead. Iatrogenic harms matter just as much, clinically and ethically, as patient- or illness-generated harms, at least in terms of policies and practices that shape inpatient environmental architecture as means by which we try to promote health outcomes as ends.
This issue of the AMA Journal of Ethics® considers policies and practices, the de facto architects and designers of psychiatric inpatients environments, which influence patients’ experiences. We welcome manuscripts expressing a wide range of perspectives from multiple stakeholders that motivate inquiry grounded in ethics, art, law, economics, risk management, history, society and culture, health professions education, and more.
Manuscripts submitted for peer review consideration and inclusion in this issue must follow Instructions for Authors and be submitted by 30 April 2023.
April 2024: Global Medical Supply Chain Security
Individual patients’ safety and public health were compromised by critical drug shortages, substandard medications, and extremely restricted access to personal protective equipment during the COVID-19 pandemic. As health organizations and workers struggled to meet demands posed by unprecedented patient numbers and illness acuity, our complex global health ecosystem with long-standing upstream supply chain vulnerabilities failed to meet emergent downstream demand in several ways. First, material procurement and ingredient sourcing were inadequate. Second, operations lacking transparency made stopping propagation of substandard or falsified medications ineffective, inefficient, or impossible. Finally, logistical obfuscation made environmental consequences of waste management hard to assess and steward responsibly. Policy makers, health care organizations, regulators, manufacturers, and distributors each have roles in building and maintaining global medical supply chain security. This theme issue investigates how these and other agents’ failures to cultivate public health capacity, nourish sustainable production processes, and carefully maintain systemic supply chain resiliency are neither accidental nor simply unfortunate, but unjust.
We invite manuscripts for the April 2024 issue of the AMA Journal of Ethics® that explore cross-disciplinary perspectives on preparing to meet demands of a next pandemic period of intense cultural, political, and economic volatility. We encourage manuscripts about strategies for bolstering supply chain functioning and welcome submissions from international stakeholders with first-hand experience of supply chain dysfunction that compromise health and health care.
Manuscripts submitted for peer review consideration and inclusion in this issue must follow Instructions for Authors and be submitted by 30 May 2023.
May 2024: Antimicrobial Resistance
Microbes include bacteria, parasites, viruses and fungi that constantly evolve. Antimicrobial resistance (AMR ) happens when microbes change, becoming harder to treat in individual human and nonhuman animals and plants with antibiotic, antiparasitic, antiviral, and antifungal agents. Resistant pathogens are more easily transmissible across human and nonhuman ecology. National and international burden of AMR has been assessed in terms of infection incidence, deaths, hospital length of stay, and location-specific costs of developing and applying specific pathogen–drug combinations to try to save lives and preserve food supplies. Routine and focused surveillance is key to understanding microbiological, individual, social, and ecological root causes, downstream effects, and sources of inequity in AMR. This theme issue canvasses neglected ethics, justice, and contextual features of AMR.
We invite manuscripts for this May 2024 issue of the AMA Journal of Ethics® that consider wide-ranging perspectives on AMR as a source of iatrogenic, zoonotic, and other harms and additional kindred topics of clinical, ethical, social, and cultural importance.
Manuscripts submitted for peer review consideration and inclusion in this issue must follow Instructions for Authors and be submitted by 30 June 2023.
June 2024: Antimicrobial Stewardship
Antimicrobial stewardship is a multisectoral field dedicated to coordinating responses to threats posed by antimicrobial resistance (AMR). This issue considers the field’s membership, organization, methods, ethical foundations, and future. Overall, responding to AMR demands prioritization of stewardship as an ethical value that guides domestic and international agencies’ and programs’ efforts to preserve antimicrobial capacity, efficacy, and effectiveness. Measures of clinicians’ and organizations’ prescription practices and patients’ uses of antibiotic, antiparasitic, antiviral, and antifungal agents are empirical cornerstones of antimicrobial stewardship. Formulating, implementing, and evaluating stewardship improvement recommendations are also key from ethical, anthropological, social, and organizational perspectives.
We invite manuscripts for this June 2024 issue of the AMA Journal of Ethics® that consider antimicrobial stewardship successes and investigate ongoing challenges from wide-ranging perspectives.
Manuscripts submitted for peer review consideration and inclusion in this issue must follow Instructions for Authors and be submitted by 30 July 2023.