Moral distress arises not only from organizational constraints on moral action but also from the environmental impacts of health care and climate change.
AMA J Ethics. 2017;19(6):617-628. doi:
10.1001/journalofethics.2017.19.6.mhst1-1706.
Targeted dosing to treat pediatric inflammatory bowel disease is challenging because dosing guidelines are based on data gathered from adult subjects of clinical trials. Patients’ families and health care organizations also incur high costs and must try to balance potential benefits against risks of ongoing monitoring.
AMA J Ethics. 2018;20(9):E841-848. doi:
10.1001/amajethics.2018.841.
Pathologists should work cooperatively with clinicians and provide guidance about appropriate testing to uphold the medical ethics principle of justice.
AMA J Ethics. 2016;18(8):793-799. doi:
10.1001/journalofethics.2016.18.8.ecas5-1608.
The allocation of scarce resources, such as HLA platelets, involves a conflict between the medical ethics principles of beneficence and social justice.
AMA J Ethics. 2016;18(8):764-770. doi:
10.1001/journalofethics.2016.18.8.ecas1-1608.
Using data from comparative effectiveness studies to inform cost-effectiveness analyses or other economic evaluations would strengthen ethical policy making.
AMA J Ethics. 2015;17(7):651-655. doi:
10.1001/journalofethics.2015.17.7.pfor1-1507.
This process of developing EBM-based guidelines and applying them to clinical care highlights the tension between generating unbiased knowledge based on statistical aggregation and the application of this information to individual patients.
Thomas W. LeBlanc, MD, MA and Amy P. Abernethy, MD, PhD
One strategy to promote adherence is the use of “care pathways,” effectively roadmaps that seek to standardize cancer treatment on the basis of some agreed-upon set of guidelines within a particular center or group of patients.
This month, AMA Journal of Ethics editor-in-chief Audiey Kao, MD, PhD, interviewed Wendy Levinson, MD, about the efforts of the Choosing Wisely initiative to foster cultural change in medicine cross-nationally by stimulating dialogue about overuse of tests and treatments