It is often difficult for the clinical team to accept a patient’s family members as allies rather than adversaries. Close relatives know more about the patient than members of the medical team and may well share some of the patient’s values.
Inquire about the patient’s current living situation. Ask about feelings of neglect or abuse and look for signs (e.g., weight loss, contusions, pressure sores, or poor hygiene) that might indicate an unsafe home environment.
False clinical and ethical dilemmas may be created when physicians ignore patient characteristics and contexts that are integral to shared decision making.
AMA J Ethics. 2017;19(2):141-146. doi:
10.1001/journalofethics.2017.19.2.ecas1-1702.
Katherine Gentry, MD, MA and Aaron Wightman, MD, MA
A patient’s refusal of tracheostomy during an anticipated difficult intubation prompts critical questions about how to best express respect for a pediatric patient’s autonomy and whether and when deviation from standard of care is clinically and ethically appropriate.
AMA J Ethics. 2018;20(8):E683-689. doi:
10.1001/amajethics.2018.683.
Alexander Craig, MPhil and Elizabeth Dzeng, MD, PhD, MPH
Eliciting the patient’s motives and goals and helping the patient and her loved ones explore alternatives are essential to maintaining trusting relationships and open communication.
AMA J Ethics. 2018;20(8):E690-698. doi:
10.1001/amajethics.2018.690.
The authors address the medical ethics question of whether autopsy is necessary from Cartesian and sociocultural perspectives and how to obtain consent.
AMA J Ethics. 2016;18(8):771-778. doi:
10.1001/journalofethics.2016.18.8.ecas2-1608.
Cytopathologists frequently interact directly with patients at their bedsides to perform fine needle aspiration procedures. When, if ever, should cytopathologists share preliminary diagnostic impressions directly with patients?
AMA J Ethics. 2016;18(8):779-785. doi:
10.1001/journalofethics.2016.18.8.ecas3-1608.