Patients who use drugs intravenously may be at high risk for relapse, but their situation is no more futile than that of persons with diabetes and coronary artery disease who smoke and frequent all-you-can-eat buffets.
“Difficult” patient encounters can be exacerbated by procedural and technological infrastructure that increases access to electronic health records (EHRs).
AMA J Ethics. 2017;19(4):374-380. doi:
10.1001/journalofethics.2017.19.4.stas1-1704.
Quality improvement initiatives in clinical medicine are part research and part patient care and pose challenges to traditional forms of ethical oversight.
The future success of the Affordable Care Act depends on doctors' willingness to take the lead in identifying reforms that will lead to high-quality, cost-effective health care.