The social institutions of medicine and the state have a complex history of interaction in which doctors have been the originators of political ideals, goals, and social change but equally often have found themselves to be instruments of political authority.
Public health and climate stabilization historically have competed for public funds, but investment in either good has the potential to advance both goods.
AMA J Ethics. 2017;19(12):1193-1201. doi:
10.1001/journalofethics.2017.19.12.pfor1-1712.
The AAP’s guidelines on lipid screening for children raise concerns about the fundamental purpose of prevention and its role in balancing individual autonomy with the benefits of society at large.
Given the well-established correlation across cultures between poverty and unhealthy lifestyles, can it be just to hold individuals responsible for choices typical of their socioeconomic sector? Aren’t patient-responsibility programs simply conspiracies to shrink benefits to the poor?
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.