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.
Marcia C. Inhorn, PhD, MPH and Pasquale Patrizio, MD, MBE
Low-cost in vitro fertilization (LCIVF) is better than no infertility treatment in countries that prohibit adoption and third-party reproductive assistance.
AMA J Ethics. 2018;20(3):228-237. doi:
10.1001/journalofethics.2018.20.3.ecas1-1803.
Patients seeking IVF are highly motivated to become parents and may wish to preserve financial resources for surrogacy or adoption should IVF not succeed, so risk sharing appeals to them, which makes its high cost especially problematic.
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.
The causes of many health behaviors are deeply rooted in our culture, and using a counseling model that assumes individual control and responsibility for these behaviors can cause patients to feel hectored instead of helped.
The Boston Health Care for the Homeless Program (BHCHP) seeks to build trusting relationships with patients before addressing their medical needs and to take account of their surrounding environment in treatment.
AMA J Ethics. 2015;17(5):469-472. doi:
10.1001/journalofethics.2015.17.5.mnar2-1505.