Katherine Gentry, MD, MA and Aaron Wightman, MD, MA
A patient’s refusal of tracheostomy during an anticipated difficult intubation prompts critical questions about how to best express respect for a pediatric patient’s autonomy and whether and when deviation from standard of care is clinically and ethically appropriate.
AMA J Ethics. 2018;20(8):E683-689. doi:
10.1001/amajethics.2018.683.
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.
Targeted dosing to treat pediatric inflammatory bowel disease is challenging because dosing guidelines are based on data gathered from adult subjects of clinical trials. Patients’ families and health care organizations also incur high costs and must try to balance potential benefits against risks of ongoing monitoring.
AMA J Ethics. 2018;20(9):E841-848. doi:
10.1001/amajethics.2018.841.
A judicious approach to autism would be to replace a “disability” or “illness” paradigm with a “diversity” perspective that takes into account both strengths and weaknesses and the idea that variation can be positive in and of itself.
AMA J Ethics. 2015;17(4):348-352. doi:
10.1001/journalofethics.2015.17.4.msoc1-1504.
In treating children with autism, physicians should reframe the common dynamic in which the family wants medication that the doctor is withholding to focus instead on the family’s and physician’s share goal—the patient’s well-being.
AMA J Ethics. 2015;17(4):299-304. doi:
10.1001/journalofethics.2015.17.4.ecas1-1504.