AMA Journal of Ethics theme editor Subha Perni, MD, a recent graduate of the Columbia University College of Physicians and Surgeons, interviewed Elizabeth Epstein, PhD, RN, about strategies for understanding and address moral distress in clinical settings.
When the patient delivers a low-birth-weight infant that requires extensive time in the neonatal intensive, should she be held responsible? Where do we draw the line? More importantly, on what basis do we draw the line?
After the infant’s birth, the neonatologist’s first duty is to his or her patient—the newly born infant. If clinical circumstances are different than anticipated, the physician must first consider the best interests of the baby.
Having implied that a particular clinical decision had been made to “free up a hospital bed,” the attending physician walked away without further comments to the residents or talking with the patient.
Approximately two-thirds of men aged 50 and older diagnosed REM sleep behavior disorder develop neurologic disease, for which there is no prevention or treatment at present.
The clinician/healer must both address the disease and seek to know how the medical condition is being experienced by the patient—what impact it has on his or her life and spirit.
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.