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.
This case is challenging because it represents a potential error on the part of the radiologist who interpreted a previous film—not the doctor who is currently treating the patient. While standards are being developed to help doctors disclose their own errors, guidelines for discussing other doctors’ errors with patients are lacking.
The growing number of web-savvy patients alters the power dynamic in the patient-physician relationship. In the older model of care, physicians served as unchallenged experts who alone devised therapeutic plans for patients.
Having implied that a particular clinical decision had been made to “free up a hospital bed,” the attending physician walked away without further comments to the residents or talking with the patient.
Approximately two-thirds of men aged 50 and older diagnosed REM sleep behavior disorder develop neurologic disease, for which there is no prevention or treatment at present.
About 80 percent of children in the ER for suturing preferred a woman doctor; 60 percent of their parents preferred a man, 19 percent, a woman, and 21 percent, the doctor with the most experience.
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.
Awareness of transference reactions, practicing active listening and reflection, pausing, and articulating one’s understanding of another’s emotional motivations can help cultivate deeper patient-clinician relationships at the end of life.
AMA J Ethics. 2018;20(8):E717-723. doi:
10.1001/amajethics.2018.717.