This month, AMA Journal of Ethics theme editor Trisha Paul, a second-year medical student at the University of Michigan Medical School, interviewed Kelly Parent about what makes patient- and family-centered care an inclusive approach to health care delivery and how this approach is being implemented.
It is often difficult for the clinical team to accept a patient’s family members as allies rather than adversaries. Close relatives know more about the patient than members of the medical team and may well share some of the patient’s values.
Inquire about the patient’s current living situation. Ask about feelings of neglect or abuse and look for signs (e.g., weight loss, contusions, pressure sores, or poor hygiene) that might indicate an unsafe home environment.
Although identical twin-to-twin skin grafting has resulted in excellent survival rates in burn patients, the nature and scope of ethical decision making in monozygotic sibling skin grafting needs further examination.
AMA J Ethics. 2018;20(6):537-545. doi:
10.1001/journalofethics.2018.20.6.cscm2-1806.
After the infant’s birth, the neonatologist’s first duty is to his or her patient—the newly born infant. If clinical circumstances are different than anticipated, the physician must first consider the best interests of the baby.
Family presence in the trauma bay is not entirely analogous to family presence during cardiopulmonary resuscitation (CPR) and requires a chaperone system.
AMA J Ethics. 2018;20(5):455-463. doi:
10.1001/journalofethics.2018.20.5.ecas5-1805.
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.
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.