The guidelines for patients’ eligibility for bariatric surgery have not changed since 1991, although recent data suggest there may be indications for broadening application of the surgery.
Advance directives, substituted judgment, and the best-interest standard all have limitations that constrain their usefulness in making medical decisions for patients who cannot choose for themselves.
Advance directives do not always resolve questions about the best care for patients who no longer have decision-making capacity; physicians and patient surrogates can take alternative approaches to arrive at the best care decision.
A discussion of the ethical issues raised by a patient’s request for off-label, prophylactic bariatric surgery to prevent diabetes mellitus type 2 (DM type 2).
A breastfed infant in a high weight-for-length percentile is not necessarily at greater risk for future health problems than a leaner infant; a physician would be justified in advocating for such a child to receive insurance coverage.
A discussion of the ethical issues raised by a patient’s request for off-label, prophylactic bariatric surgery to prevent diabetes mellitus type 2 (DM type 2).
Physicians can fulfill their professional responsibilities to patients when those responsibilities conflict with moral commitments of the hospital or clinic where the patient encounter occurs.
Frank A. Chervenak, MD and Laurence B. McCullough, PhD
Physicians can fulfill their professional responsibilities to patients when those responsibilities conflict with moral commitments of the hospital or clinic where the patient encounter occurs.
Medical technology presents a new ethical question in the case of a patient with a left ventricular assist device who, when informed that he has pneumonia and is ineligible for a heart transplant, asks that the LVAD be turned off.