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.
This commentary on a case considers the ethical feasibility of palliative psychiatry in the care of patients with severe and enduring anorexia nervosa.
Jonathan Treem, MD, Joel Yager, MD, and Jennifer L. Gaudiani, MD, CEDS-S
Some individuals with severe and enduring anorexia nervosa experience dramatically degraded quality of life in the face of refractory illness and compulsory treatment.
Dr Jonathan Treem joins Ethics Talk to discuss his article, coauthored with Drs Joel Yager and Jennifer L. Gaudiani: “A Life-Affirming Palliative Care Model for Severe and Enduring Anorexia Nervosa.”
The communication gulf is not only one of language, but also one of culture, understood broadly. And, despite the priority of medical concerns, every effort should be made to obtain consent consistent with appropriate care.
Industrialized nations could benefit from strategies emerging in developing nations such as respectful collaboration between traditional out-of-hospital birthing practices and maternity units in partnering hospitals.