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.
In treating children with autism, physicians should reframe the common dynamic in which the family wants medication that the doctor is withholding to focus instead on the family’s and physician’s share goal—the patient’s well-being.
AMA J Ethics. 2015; 17(4):299-304. doi:
10.1001/journalofethics.2015.17.4.ecas1-1504.
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.
After assessing the reasons for a patient’s unrealistic hopefulness in the face of clear understanding, a clinician may believe that significant harm will come to the patient if he or she does not acknowledge the seriousness of the illness.
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.”
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.