When patients are unable to express their wishes and do not have surrogates or advance directives, which and whose values should inform decision making for them? We discuss ethical complexities of caring for unrepresented patients.
Ruth L. Ackah, MD, Rohini R. Sigireddi, and Bhamidipati V. R. Murthy, MD
Although undocumented immigrants contribute to the pool of available organs and to the US tax base, they are not eligible for organ transplantation in most US states.
AMA J Ethics. 2019;21(1):E17-25. doi:
10.1001/amajethics.2019.17.
A guardian’s request to sterilize a woman with intellectual disabilities is not ethically justifiable unless the woman assents and it is to her benefit.
AMA J Ethics. 2016;18(4):365-372. doi:
10.1001/journalofethics.2016.18.4.ecas2-1604.
Shared decision making honors patient autonomy, particularly for preference-sensitive care decisions and even when patients have impaired decision-making capacity.
AMA J Ethics. 2020;22(5):E358-364. doi:
10.1001/amajethics.2020.358.
William F. Parker, MD, MS and Marshall H. Chin, MD, MPH
Given organ scarcity, transplantation programs state that patient promises of compliance cannot be taken at face value, excluding candidates who are deemed untrustworthy.
AMA J Ethics. 2020;22(5):E408-415. doi:
10.1001/amajethics.2020.408.
Shared decision making is practically difficult to implement in mental health practice but remains an ethical ideal for motivating therapeutic capacity.
AMA J Ethics. 2020;22(5):E446-451. doi:
10.1001/amajethics.2020.446.
Drs Katrina Bramstedt and Ana Iltis discuss the development of QoL assessment tools to help patient-subjects considering reconstructive transplantation.