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.
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.
The social-justice question we must pose to physicians is: Are you willing to advocate for changes to the medical system that creates the need for you to take on charity care in the first place?
The importance of the Oregon experiment is that the state developed a public process for prioritizing medical services rather than relying on undisclosed private decisions by individuals or insurers.
If I am unwilling to pay more taxes so an 85-year-old stranger can have a left-ventricular assist device, then I am morally obligated to say the same holds true for a future version of me in those same circumstances.