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.
Treatment decisions in high-risk situations require a dynamic relationship between doctor and patient in which patient preferences and clinician recommendations contribute equally in shaping a final treatment decision.
In the same way that we learn about normal variations in blood pressure, we need to learn about “normal” variations in sexual interests and practices. We want to avoid clueless questions or unintentionally inflammatory statements.
My most important job is to help my patients (and their families) who are depressed, grieving, or angry following severe injury or illness to imagine possible narratives for the next chapter of life.
AMA J Ethics. 2015;17(6):500-505. doi:
10.1001/journalofethics.2015.17.6.ecas1-1506.
There are two main approaches to telling patient stories in medical memoir. One is securing informed consent from the patients whose stories we tell; the other is de-identification. Each of these, however, creates new problems.