Insights on Value and Values From Decision Science for Clinical Ethics

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, and cultural dimensions of applying decision science to actual decision making in ethically complex cases in health care settings. 

Volume 21, Number 10: E823-929 Full Issue PDF
  • From the Editor
    Oct 2019

    The Value of Decision Science for Clinical Ethics

    Raymond De Vries, PhD
    Despite disciplinary diversity in bioethics, decision science is still needed to motivate the quality of clinical and research ethics.
    AMA J Ethics. 2019;21(10):E825-830. doi: 10.1001/amajethics.2019.825.
  • Case and Commentary
    Oct 2019

    How Should We Determine the Value of CAR T-Cell Therapy?

    Sara Silbert, MD, Gregory A. Yanik, MD, and Andrew G. Shuman, MD
    “Living” drugs target specific B-cell malignancy tumor antigens, but cost hundreds of thousands of dollars. Value analysis can help determine whether to offer these customized drugs.
    AMA J Ethics. 2019;21(10):E844-851. doi: 10.1001/amajethics.2019.844.
  • Case and Commentary
    Oct 2019

    How Should Decision Science Inform Scarce Blood Product Allocation?

    Eric Kersjes, MD and Lauren B. Smith, MD
    Decision aids could help clinicians know when to request ethics consultation or re-evaluate blood product usage in a specific patient care situation.
    AMA J Ethics. 2019;21(10):E852-857. doi: 10.1001/amajethics.2019.852.
  • Art of Medicine
    Oct 2019

    When Good Women Decide to Do Nothing

    Phoebe Cohen
    A graphic memoir documents clinical and ethical disagreements and decision points throughout a paramedic team’s time with an incarcerated patient in labor.
    AMA J Ethics. 2019;21(10):E902-903. doi: 10.1001/amajethics.2019.902.
  • Art of Medicine
    Oct 2019

    A Matter of Words

    Jessica S. Yang
    Word Choices is a mixed-media digital illustration that explores the importance of clinicians’ word choices during their encounters with patients. Clinicians often face ethical questions about sharing information with vulnerable patients.
    AMA J Ethics. 2019;21(10):E904-905. doi: 10.1001/amajethics.2019.904.
  • Viewpoint
    Oct 2019

    What Clinical Ethics Can Learn From Decision Science

    Michele C. Gornick, PhD, MA and Brian J. Zikmund-Fisher, PhD, MA
    How information is provided can change a choice. Decision science helps reveal affective forecasting errors and can generate choices congruent with patients’ and families’ values.
    AMA J Ethics. 2019;21(10):E906-912. doi: 10.1001/amajethics.2019.906.
  • Viewpoint
    Oct 2019

    How Moral Case Deliberation Supports Good Clinical Decision Making

    Giulia Inguaggiato, MPhil, Suzanne Metselaar, PhD, Bert Molewijk, PhD, and Guy Widdershoven, PhD
    Clarifying both patients’ and professionals’ values fosters good clinical decision making, particularly in situations of uncertainty.
    AMA J Ethics. 2019;21(10):E913-919. doi: 10.1001/amajethics.2019.913.
  • Letter to the Editor
    Oct 2019

    Response to “Emerging Roles of Virtual Patients in the Age of AI”

    Frederick W. Kron, MD, Timothy C. Guetterman, PhD, and Michael D. Fetters, MD, MPH, MA
    Selected ideas in C. Donald Combs and P. Ford Combs’ article, “Emerging Roles of Virtual Patients in the Age of AI,” are further considered.
    AMA J Ethics. 2019;21(10):E920-925. doi: 10.1001/amajethics.2019.920.
  • podcast-1910
    Podcast
    Oct 2019

    Ethics Talk: How Can Decision Science Help Navigate Complex Health Decisions?

    Decision making in health care demands that we balance multiple considerations, like quality of life, statistics, and how different options could affect others. Dr Brian Zikmund-Fisher shares his own experience as a patient and explains how decision science can help us navigate ethically complex health decisions.