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.
Targeted dosing to treat pediatric inflammatory bowel disease is challenging because dosing guidelines are based on data gathered from adult subjects of clinical trials. Patients’ families and health care organizations also incur high costs and must try to balance potential benefits against risks of ongoing monitoring.
AMA J Ethics. 2018;20(9):E841-848. doi:
10.1001/amajethics.2018.841.
Given full information about the risks of long-term opioid therapy, patients often see the value of exploring other options rather than thinking their physicians are reluctant to prescribe narcotics for fear of litigation or regulatory action.
AMA J Ethics. 2015;17(3):202-208. doi:
10.1001/journalofethics.2015.17.3.ecas1-1503.