When a child or family begins to stand out because of patterns in history or physical findings, physicians must determine whether to take a closer look at the situation.
Given the well-established correlation across cultures between poverty and unhealthy lifestyles, can it be just to hold individuals responsible for choices typical of their socioeconomic sector? Aren’t patient-responsibility programs simply conspiracies to shrink benefits to the poor?
Undocumented patients in the United States with end-stage renal disease receive “compassionate” dialysis. Such patients oscillate between being marginally well and “ill enough” to receive dialysis while clinicians wrestle with complicity in a system that both offers and withholds life-saving therapy.
AMA J Ethics. 2018;20(8):E778-779. doi:
10.1001/amajethics.2018.778.
Katrina A. Bramstedt, PhD and Francis L. Delmonico, MD
Transplant centers cannot regulate how people establish relationships, but when a donor-recipient pair comes together through Internet solicitation, the center must assess the donor’s motivations carefully.
Industrialized nations could benefit from strategies emerging in developing nations such as respectful collaboration between traditional out-of-hospital birthing practices and maternity units in partnering hospitals.
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.
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.