AMA Journal of Ethics theme editor Subha Perni, MD, a recent graduate of the Columbia University College of Physicians and Surgeons, interviewed Elizabeth Epstein, PhD, RN, about strategies for understanding and address moral distress in clinical settings.
Barriers to effective prognosis conversations include knowledge deficits, misconceptions, cultural differences, and lack of motivation. These can be addressed head-on by good communication interventions.
AMA J Ethics. 2018;20(8):E757-765. doi:
10.1001/amajethics.2018.757.
Transparency about teaching hospitals’ educational mission respects patient autonomy and aligns patients’ interests with those of trainees and the public.
AMA J Ethics. 2017;19(6):537-543. doi:
10.1001/journalofethics.2017.19.6.ecas1-1706.
Thomas W. LeBlanc, MD, MA, MHS and Arif H. Kamal, MD, MBA, MHS
Clinical trials should assess patients’ distress and test interventions to address it, just as they assess adverse events and test novel therapeutic agents.
AMA J Ethics. 2017;19(5):460-466. doi:
10.1001/journalofethics.2017.19.5.stas1-1705.
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.
Nonmaleficence must not be sacrificed in the name of the patient’s autonomy, but there is no need to undertake needlessly invasive treatments for a small boost in protection against cancer recurrence if the patient does not wish to do so.