AMA Journal of Ethics theme editor Emily Johnson, a fourth-year medical student at the University of Colorado School of Medicine, interviewed Susan Mizner, JD, about some merits, drawbacks, and alternatives to guardianship.
Critical skills required to weigh decisions with serious consequences, manipulate information rationally, and choose wisely are skills that are likely to be impaired by frontal lobe injury that results in personality change.
Using the patient’s worldview to challenge his or her decision and establish a treatment plan—implying the view is shared by the physician when it is not—could be seen as manipulative and deceptive.
Katherine Gentry, MD, MA and Aaron Wightman, MD, MA
A patient’s refusal of tracheostomy during an anticipated difficult intubation prompts critical questions about how to best express respect for a pediatric patient’s autonomy and whether and when deviation from standard of care is clinically and ethically appropriate.
AMA J Ethics. 2018;20(8):E683-689. doi:
10.1001/amajethics.2018.683.