Physicians make patients aware of those interventions that they (the patients) may then refuse. In short, informed consent is less about patient decisions than it is about restraining physicians.
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.
The question is whether the medi-spa is a consumer-driven, profit-motivated business that happens to fall under the purview of medical practice or a legitimate and integral part of the health care system? Does it fulfill consumers’ desires or relieve suffering and promote wellness?
Is our generation of physicians somehow “weaker” because we’d rather not spend our entire lives at the office? Physicians who trained and practiced under more grueling conditions wonder how we expect to be competent physicians if we don’t work at it?
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.