The growing number of web-savvy patients alters the power dynamic in the patient-physician relationship. In the older model of care, physicians served as unchallenged experts who alone devised therapeutic plans for patients.
Society values both the appropriate use of new technological and management innovations and the maintenance of a strong personal and therapeutic relationship between patients and physicians. The medical-home model may be able to accomplish both.
Caregivers often think that so-called “frequent-flyer” patients are at fault for their poor medical outcomes. In many such cases, though, unaddressed psychosocial issues are the root of the patients’ repeat visits to the emergency department.
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.
About 80 percent of children in the ER for suturing preferred a woman doctor; 60 percent of their parents preferred a man, 19 percent, a woman, and 21 percent, the doctor with the most experience.
Anyone who has substantiated suspicion of ethical misconduct in research has a responsibility to report that suspicion to the appropriate authorities. He or she should not gossip about suspected misconduct with friends, colleagues, or others.
Public and private choices about allocation of funds for research raise a social-justice question: are these funding sources making fair decisions about where to invest their resources? The NIH has the clearest obligation to do so because it is taxpayer-supported.
The question that comes to mind when one considers the risks of a clinical trial is, “Why would anyone agree to participate?” Interviews with trial volunteers and their family members make clear that often it is the appeal of discovering something new and unknown.
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.