Mark Pfeifer, MD and Barbara A. Head, PhD, CHPN, ACSW
Interdisciplinary support, securing reliable information from a patient’s health record, and taking a “who, what, when, where, and how” approach to conversation can improve care planning with dying patients and their loved ones.
AMA J Ethics. 2018;20(8):E724-731. doi:
10.1001/amajethics.2018.724.
When a would-be living organ donor wants to accept risk in the name of altruism when there is little chance for benefit or significant chance for harm, physicians are justified in limiting that altruism.
While respecting patient autonomy and involving patients in decision making, physicians must recognize that some situations call for them to exercise selective paternalism in order to fulfill their professional duty to uphold standards of care.
To succeed in accountable care organizations, physicians will need to learn to emphasize collaboration rather than authority, keep costs in mind, and encourage patients to plan in advance for palliative care and death.