Palliative psychiatry can facilitate compassionate resolution of ethical conflicts in end-of-life care decision making with persons with substance use disorders.
AMA J Ethics. 2023;25(9):E678-683. doi:
10.1001/amajethics.2023.678.
Dr Anna L. Westermair joins Ethics Talk to discuss her article, coauthored with Dr Manuel Trachsel: “Moral Intuitions About Futility as Prompts for Evaluating Goals in Mental Health Care.”
Dr Amy Johnson joins Ethics Talk to discuss clinical end-of-life skills that psychiatrists need to have to care well for patients with terminal psychiatric illnesses.
The objective is to compare the costs of providing the same level of quality. When resource-use and quality measures are juxtaposed, the resources used to provide the same level of quality can be compared.
Measuring outcomes alone is not the answer. There should be a way to reward the doctor for educating a patient about lifestyle modifications and then documenting that the care provided followed patient preferences.
The picture that emerges from study of physician economic behavior is mixed, but from the intensity of responses by some professional societies to Medicare's coding modifier proposal, it appears that economic incentives matter a lot to many of their members.
This process of developing EBM-based guidelines and applying them to clinical care highlights the tension between generating unbiased knowledge based on statistical aggregation and the application of this information to individual patients.