Given the well-established correlation across cultures between poverty and unhealthy lifestyles, can it be just to hold individuals responsible for choices typical of their socioeconomic sector? Aren’t patient-responsibility programs simply conspiracies to shrink benefits to the poor?
Undocumented patients in the United States with end-stage renal disease receive “compassionate” dialysis. Such patients oscillate between being marginally well and “ill enough” to receive dialysis while clinicians wrestle with complicity in a system that both offers and withholds life-saving therapy.
AMA J Ethics. 2018;20(8):E778-779. doi:
10.1001/amajethics.2018.778.
Caregiver trustworthiness and a competent patient’s prerogative to return to suboptimal living conditions are critical considerations in discharge planning.
AMA J Ethics. 2015;17(6):506-510. doi:
10.1001/journalofethics.2015.17.6.ecas2-1506.
Fabian M. Saleh, MD and H. Martin Malin, PhD, MA, LMFT
In treating patients whose sexual fantasies do not trigger an immediate legal duty to report, psychiatrists must be vigilant for signs that the patient intends to act on a fantasy.
The legal definition of a patient and the corresponding duties of the physician have been debated in state courts for over a century, and many aspects of the question are still unresolved.
Industrialized nations could benefit from strategies emerging in developing nations such as respectful collaboration between traditional out-of-hospital birthing practices and maternity units in partnering hospitals.