Dr Art Walaszek joins Ethics Talk to discuss his article, coauthored with Drs William Smith and David Elkin: “How to Draw on Narrative to Mitigate Ageism.”
Caregiver trustworthiness and a competent patient’s prerogative to return to suboptimal living conditions are critical considerations in discharge planning.
AMA J Ethics. 2015;17(6):506-510. doi:
10.1001/journalofethics.2015.17.6.ecas2-1506.
The physician must help patients understand that all options—further testing, surgery, no action—carry risks and benefits. Disclosing the statistical probability of injury and other possible outcomes might help, but it can also hinder the process.
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.
Fabian M. Saleh, MD and H. Martin Malin, PhD, MA, LMFT
In treating patients whose sexual fantasies do not trigger an immediate legal duty to report, psychiatrists must be vigilant for signs that the patient intends to act on a fantasy.
The legal definition of a patient and the corresponding duties of the physician have been debated in state courts for over a century, and many aspects of the question are still unresolved.