Cytopathologists frequently interact directly with patients at their bedsides to perform fine needle aspiration procedures. When, if ever, should cytopathologists share preliminary diagnostic impressions directly with patients?
AMA J Ethics. 2016;18(8):779-785. doi:
10.1001/journalofethics.2016.18.8.ecas3-1608.
Given full information about the risks of long-term opioid therapy, patients often see the value of exploring other options rather than thinking their physicians are reluctant to prescribe narcotics for fear of litigation or regulatory action.
AMA J Ethics. 2015;17(3):202-208. doi:
10.1001/journalofethics.2015.17.3.ecas1-1503.
The communication gulf is not only one of language, but also one of culture, understood broadly. And, despite the priority of medical concerns, every effort should be made to obtain consent consistent with appropriate care.
Fibromyalgia, with no positive tests, is a “foreigner” in the medical landscape. Medicine looks for signs of pathology, changes in the structure or function of organs. The mantra of physicians facing patients with fibromyalgia: “Your tests are normal.”
Discussing CAM offers an opportunity to study the development of basic medical science that refuted vitalism, homeopathy, humoral theory, miasma theory, the doctrine of signatures, and other prescientific myths that persist today.
Beyond consensus that pain is “an unpleasant sensory and emotional experience,” its biology remains poorly understood, and options for its treatment remain frustratingly inadequate.
Jack M. Berger, MS, MD, PhD and Nalini Vadivelu, MD
Guidelines for the use of controlled substances for the treatment of pain now consider inappropriate treatment, including undertreatment of pain, a departure from an acceptable standard of practice.