Dr David Marcus joins Ethics Talk to discuss his article: “When, If Ever, Is It Appropriate to Regard a Patient as ‘Too Medically Complex’ for One Inpatient Service, But Not Another?”
Medicine is a service industry, the product of which is health care, and its practitioners deserve remuneration. But to some, the notion of medicine as a road to personal wealth is an example of free-market economics gone awry.
AMA J Ethics. 2015;17(8):780-786. doi:
10.1001/journalofethics.2015.17.8.msoc1-1508.
Treatment decisions in high-risk situations require a dynamic relationship between doctor and patient in which patient preferences and clinician recommendations contribute equally in shaping a final treatment decision.
Constraints on hospitalists and surgeons and restricted orthopedic admission criteria can exacerbate patients’ distress that comes from clinicians’ disagreements.
AMA J Ethics. 2023;25(12):E873-877. doi:
10.1001/amajethics.2023.873.
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.