One of the many doors money and power often open gives access to opioids where they would otherwise be withheld without strict oversight and management. Elvis Presley provides perhaps the most famous example of unmanaged access to drugs.
In the iconic painting Broken Column, Kahlo represents her spine as a Greek column that is fractured and disintegrating. In this beautiful and tragic interpretation, the fractured column bespeaks Kahlo’s physical weakness and emotional instability.
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.
Tracy Shamas, MSN, APRN and Sarah Gillespie-Heyman, MSN, APRN
Veterans at the end of life have special needs due to posttraumatic stress disorder, environmental exposures, and the influence of military culture on their values. Those who die outside the Veterans Affairs health care system, however, can be at increased risk for receiving outpatient palliative care that is not sensitive to these factors.
AMA J Ethics. 2018;20(8):E787-792. doi:
10.1001/amajethics.2018.787.
Dr Jane Lee joins Ethics Talk to discuss her article, coauthored with Drs Gabriel Robles and Latoya Small: “What Should Students Learn About the Importance of Cultural Brokering in Immigrant Communities?”
Given full information about the risks of long-term opioid therapy, patients often see the value of exploring other options rather than thinking their physicians are reluctant to prescribe narcotics for fear of litigation or regulatory action.
AMA J Ethics. 2015;17(3):202-208. doi:
10.1001/journalofethics.2015.17.3.ecas1-1503.