Dr Jo Ellen Wilson joins Ethics Talk to discuss her article, coauthored with Drs Jennifer M. Connell and Maria C. Duggan: “Why We Must Prevent and Appropriately Manage Delirium.”
Victims of sexual violence who are minors should not be forced to submit to a rape kit exam against their wishes since it might retraumatize the patient.
AMA J Ethics. 2018;20(1):36-43. doi:
10.1001/journalofethics.2018.20.1.ecas2-1801.
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.
Trauma-informed care ensures ethical treatment for children experiencing physical or psychological distress associated with a medical event or procedure.
AMA J Ethics. 2017;19(8):793-801. doi:
10.1001/journalofethics.2017.19.8.pfor1-1708.
The physician must help patients understand that all options—further testing, surgery, no action—carry risks and benefits. Disclosing the statistical probability of injury and other possible outcomes might help, but it can also hinder the process.
After assessing the reasons for a patient’s unrealistic hopefulness in the face of clear understanding, a clinician may believe that significant harm will come to the patient if he or she does not acknowledge the seriousness of the illness.
Requirements for informed consent are relatively vague and the exceptions are few, so it is in the physician’s best interest to inform patients about proposed treatment options, ascertain that they understand their choices, and secure their consent.
The communication gulf is not only one of language, but also one of culture, understood broadly. And, despite the priority of medical concerns, every effort should be made to obtain consent consistent with appropriate care.
Fibromyalgia, with no positive tests, is a “foreigner” in the medical landscape. Medicine looks for signs of pathology, changes in the structure or function of organs. The mantra of physicians facing patients with fibromyalgia: “Your tests are normal.”