Using the patient’s worldview to challenge his or her decision and establish a treatment plan—implying the view is shared by the physician when it is not—could be seen as manipulative and deceptive.
This case illustrates how emergency physicians find themselves with an empty toolbox and must compromise to meet their responsibilities to patients and themselves.
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.
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.