Thomas W. LeBlanc, MD, MA and Amy P. Abernethy, MD, PhD
One strategy to promote adherence is the use of “care pathways,” effectively roadmaps that seek to standardize cancer treatment on the basis of some agreed-upon set of guidelines within a particular center or group of patients.
There are few situations in which the standard of care is so clear-cut as to preclude physician judgment. Assessing the degree of need (not just the standard of care) when asking a patient to spend money requires judgment.
The causes of many health behaviors are deeply rooted in our culture, and using a counseling model that assumes individual control and responsibility for these behaviors can cause patients to feel hectored instead of helped.
Jodi Halpern, MD, PhD and Richard L. Kravitz, MD, MSPH
Just as people frequently support political parties without endorsing their entire platforms, perhaps physicians can support a health care advocacy organization without agreeing with its screening guidelines.
The primary care physician and activist Dr. Gordon Schiff advises those advocating for systemic change to set priorities, work with others, and realize the power of small actions.
AMA J Ethics. 2015;17(5):465-468. doi:
10.1001/journalofethics.2015.17.5.mnar1-1505.
The Boston Health Care for the Homeless Program (BHCHP) seeks to build trusting relationships with patients before addressing their medical needs and to take account of their surrounding environment in treatment.
AMA J Ethics. 2015;17(5):469-472. doi:
10.1001/journalofethics.2015.17.5.mnar2-1505.
This month, AMA Journal of Ethics' theme editor, Nadi N. Kaonga, a medical student and predoctoral candidate at Tufts University in Boston, interviewed Gordon D. Schiff, MD, on reframing professional boundaries in the patient-physician relationship.
The high price of cancer drugs in the US relative to European countries with universal health care raises ethical issues of access, financial burden on patients, and unsustainability of the health care system.
AMA J Ethics. 2015;17(8):750-753. doi:
10.1001/journalofethics.2015.17.8.nlit1-1508.
The Orphan Drug Act of 1983 provides incentives to encourage the development of drugs for rare diseases, but available orphan drugs tend to be expensive and targeted to the more common of the rare diseases.
AMA J Ethics. 2015;17(8):776-779. doi:
10.1001/journalofethics.2015.17.8.pfor2-1508.
If a medical decision about high-value care involves a conflict between the principles of beneficence and justice, an explicit analysis of the individual case is necessary to ensure that the interests of both the patient and society are served.
AMA J Ethics. 2015;17(11):1022-1027. doi:
10.1001/journalofethics.2015.17.11.ecas1-1511.