Clinicians have an ethical obligation to provide high-quality care to incarcerated and justice-involved patients, which means being knowledgeable and empathic about the challenges these patients face. This month, we explore patient, student, and clinician perspectives on correctional health care.
This month, AMA Journal of Ethics theme editor Marguerite Reid Schneider, a fourth-year medical student at University of Cincinnati College of Medicine, interviewed Srijan Sen, MD, PhD, about how mental health care and medical culture can be changed to benefit medical trainees.
Prison patients are never alone and never without supervision and rules, and the medical staff is always negotiating its power with the adminsitration. The patient-doctor relationship can become distorted in this setting.
Those in prison are less healthy than the general population, are far more likely to have engaged in high-risk behaviors that can result in organ damage, disease and disability, and age more rapidly than nonincarcerated individuals do.
William J. Rifkin, Rami S. Kantar, MD, Safi Ali-Khan, Natalie M. Plana, J. Rodrigo Diaz-Siso, MD, Manos Tsakiris, PhD, MSc, and Eduardo D. Rodriguez, MD, DDS
Facial transplantation provides a viable option for those patients with severe facial defects who are more likely to adapt to their new facial appearance.
AMA J Ethics. 2018;20(4):309-323. doi:
10.1001/journalofethics.2018.20.4.peer1-1804.
The greatest pressure to resuscitate the extremely low-birth-weight infant often results from successful marketing efforts that lead families to expect that their premature infants will be cute and healthy.
Physicians new to a case might object to an established care plan. Practice variation, clinical momentum, and how value is assigned by different parties to acute care and comfort measures can each contribute to conflict in these cases.
AMA J Ethics. 2018;20(8):E699-707. doi:
10.1001/amajethics.2018.699.
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.
Giving undocumented immigrants and those with DACA status (DREAMers) access to health care and medical education enables them to contribute to these systems.
AMA J Ethics. 2017;19(3):221-233. doi:
10.1001/journalofethics.2017.19.3.peer1-1703.