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.

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.

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.

Undocumented patients in the United States with end-stage renal disease receive “compassionate” dialysis. Such patients oscillate between being marginally well and “ill enough” to receive dialysis while clinicians wrestle with complicity in a system that both offers and withholds life-saving therapy.

Caring well for dying patients requires understanding how prognosis, culture, policy, and training shape physicians’ capacities to communicate with and care for dying patients.

Clinical momentum—increasingly aggressive treatment in intensive care settings that can violate a patient’s wishes—is charged by ritually intensifying efforts to “save” a patient, reimbursement patterns that privilege acute interventions, and technology-driven health care.

Interdisciplinary support, securing reliable information from a patient’s health record, and taking a “who, what, when, where, and how” approach to conversation can improve care planning with dying patients and their loved ones.

This image depicts a dying elder undergoing cardiopulmonary resuscitation, suggesting consideration of the ethical weight of the invasiveness and force of chest compressions.

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.

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.