Clinicians must avoid violating professional ethical principles and patients’ legal rights and they may not ever discriminate. So, what does that mean in practice?
AMA J Ethics. 2016;18(3):229-236. doi:
10.1001/journalofethics.2016.18.3.ecas4-1603.
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.
An emerging medical ethics issue is whether to delay posting pathology reports to electronic health records (EHR) to allow clinicians time to follow up.
AMA J Ethics. 2016;18(8):826-832. doi:
10.1001/journalofethics.2016.18.8.pfor1-1608.
Laurel J. Lyckholm, MD and Arwa K. Aburizik, MD, MS
Decision-making capacity can be preserved in patients with mental illness and should be formally assessed in the context of their values and past decisions.
AMA J Ethics. 2017;19(5):444-453. doi:
10.1001/journalofethics.2017.19.5.ecas4-1705.
Margaret Little, PhD and Anne Drapkin Lyerly, MA, MD
Society is best served by an approach to conscience that combines a progressive understanding of patients’ needs, a nuanced determination of when those needs translate into claims, and a limited role for conscientious refusal.
Informed assent, in which the family or surrogate decision makers for a patient are invited to defer to clinicians' judgment rather than specifically consenting to withholding or withdrawing futile treatments, is consistent with quality care and may protect surrogates from feeling responsible for the patient’s death.
Even seasoned doctors can have trouble confronting the topic of death. For medical students, training and role modeling are needed to make them valuable to patients facing death.
Situations in which the patient’s family seems not to be acting in good faith or the patient's suffering is uncontrollable are relatively rare and do not warrant giving physicians unilateral power to withhold or withdraw treatment in all cases of perceived medical futility.