When patients are unable to express their wishes and do not have surrogates or advance directives, which and whose values should inform decision making for them? We discuss ethical complexities of caring for unrepresented patients.
Many pregnant undocumented immigrants are ineligible for public insurance covering prenatal care. National and state policies can either help or hinder patients’ access to health care that is universally recommended by professional guidelines.
AMA J Ethics. 2019;21(1):E93-99. doi:
10.1001/amajethics.2019.93.
A guardian’s request to sterilize a woman with intellectual disabilities is not ethically justifiable unless the woman assents and it is to her benefit.
AMA J Ethics. 2016;18(4):365-372. doi:
10.1001/journalofethics.2016.18.4.ecas2-1604.
Women who are pregnant might not treat their mental illnesses because they overestimate risks of medication and underestimate risks of leaving their illness untreated.
AMA J Ethics. 2016;18(6):614-623. doi:
10.1001/journalofethics.2016.18.6.stas1-1606.
Efrat Lelkes, MD, Angira Patel, MD, MPH, Anna Joong, MD, and Jeffrey G. Gossett, MD
Current policy requires separate informed consent for some Public Health Service increased-risk donors, and this can make shared decision making harder.
AMA J Ethics. 2020;22(5):E401-407. doi:
10.1001/amajethics.2020.401.
Shared decision making honors patient autonomy, particularly for preference-sensitive care decisions and even when patients have impaired decision-making capacity.
AMA J Ethics. 2020;22(5):E358-364. doi:
10.1001/amajethics.2020.358.
Haley Moulton, Benjamin Moulton, JD, MPH, Tim Lahey, MD, MMSc, and Glyn Elwyn, MD, PhD, MSc
Shared decision making in research informed consent conversations is complex due to diverse and potentially divergent interests of investigators and patient-subjects.
AMA J Ethics. 2020;22(5):E365-371. doi:
10.1001/amajethics.2020.365.