A major contributor to the lack of medicines in developing countries is an intellectual property regime that allows proprietary drug companies with intellectual property monopolies to charge high prices and maximize profit.
Awareness of transference reactions, practicing active listening and reflection, pausing, and articulating one’s understanding of another’s emotional motivations can help cultivate deeper patient-clinician relationships at the end of life.
AMA J Ethics. 2018;20(8):E717-723. doi:
10.1001/amajethics.2018.717.
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.
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.