This case illustrates how emergency physicians find themselves with an empty toolbox and must compromise to meet their responsibilities to patients and themselves.
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.
The clinician/healer must both address the disease and seek to know how the medical condition is being experienced by the patient—what impact it has on his or her life and spirit.
A major contributor to the lack of medicines in developing countries is an intellectual property regime that allows proprietary drug companies with intellectual property monopolies to charge high prices and maximize profit.
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.