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.
Society values both the appropriate use of new technological and management innovations and the maintenance of a strong personal and therapeutic relationship between patients and physicians. The medical-home model may be able to accomplish both.
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.
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.
Alexander Craig, MPhil and Elizabeth Dzeng, MD, PhD, MPH
Eliciting the patient’s motives and goals and helping the patient and her loved ones explore alternatives are essential to maintaining trusting relationships and open communication.
Emily L. Evans, PhD, MPH and Danielle Whicher, PhD, MHS
Clinical decision support systems leverage data generated in the course of standard clinical care to improve clinical practice. They need to ensure privacy and quality of patients’ data, but must also allow queries of electronic health records.