AMA Journal of Ethics theme editor Emily Johnson, a fourth-year medical student at the University of Colorado School of Medicine, interviewed Susan Mizner, JD, about some merits, drawbacks, and alternatives to guardianship.
Prison patients are never alone and never without supervision and rules, and the medical staff is always negotiating its power with the adminsitration. The patient-doctor relationship can become distorted in this setting.
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.
An older generation was far more likely to understand itself and its social world in terms of sin and virtue, vice and godliness. Lack of self-control and weakness of will were moral failings to be avoided. That sort of language has fallen on hard times.
Those in prison are less healthy than the general population, are far more likely to have engaged in high-risk behaviors that can result in organ damage, disease and disability, and age more rapidly than nonincarcerated individuals do.
Although sharing health records with psychiatric patients may cause harm, clinicians also must consider beneficence and autonomy in making this decision.
AMA J Ethics. 2017;19(3):253-259. doi:
10.1001/journalofethics.2017.19.3.ecas3-1703.
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.
Giving undocumented immigrants and those with DACA status (DREAMers) access to health care and medical education enables them to contribute to these systems.
AMA J Ethics. 2017;19(3):221-233. doi:
10.1001/journalofethics.2017.19.3.peer1-1703.