One way of transmitting culture is through narrative scripts—ideas about the kind of self one ought to become—that shape medical students’ ideas of what desires, attitudes, behaviors, and dispositions are expected or unbecoming of professionals.
AMA J Ethics. 2015;17(2):160-166. doi:
10.1001/virtualmentor.2015.17.2.msoc1-1502.
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.
Dr Anna L. Westermair joins Ethics Talk to discuss her article, coauthored with Dr Manuel Trachsel: “Moral Intuitions About Futility as Prompts for Evaluating Goals in Mental Health Care.”
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.
Web-based physician rating sites are part of a multi-decade cultural shift in the relationship between physicians, patients, and society. But a system in which “patient’s orders” reign is just as lopsided as one that puts “doctor’s orders” in the driver’s seat.
The eradication of hazing has not diminished the socialization, camaraderie, or commitment of new recruits. The physical, emotional, and mental demands of basic training suffice to produce the outcomes previously ascribed to hazing.