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.
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.
Medicine is a service industry, the product of which is health care, and its practitioners deserve remuneration. But to some, the notion of medicine as a road to personal wealth is an example of free-market economics gone awry.
AMA J Ethics. 2015;17(8):780-786. doi:
10.1001/journalofethics.2015.17.8.msoc1-1508.