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.
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.
Barriers to effective prognosis conversations include knowledge deficits, misconceptions, cultural differences, and lack of motivation. These can be addressed head-on by good communication interventions.
AMA J Ethics. 2018;20(8):E757-765. doi:
10.1001/amajethics.2018.757.
Tracy Shamas, MSN, APRN and Sarah Gillespie-Heyman, MSN, APRN
Veterans at the end of life have special needs due to posttraumatic stress disorder, environmental exposures, and the influence of military culture on their values. Those who die outside the Veterans Affairs health care system, however, can be at increased risk for receiving outpatient palliative care that is not sensitive to these factors.
AMA J Ethics. 2018;20(8):E787-792. doi:
10.1001/amajethics.2018.787.
Joel A. DeLisa, MD, MS and Jacob Jay Lindenthal, PhD, DrPH
Research on experiences of practicing physicians who have disabilities could help medical schools counsel applicants and increase enrollment among students with disabilities. This can ultimately improve care for patients with disabilities.
AMA J Ethics. 2016;18(10):1003-1009. doi:
10.1001/journalofethics.2016.18.10.stas1-1610.
The physician must help patients understand that all options—further testing, surgery, no action—carry risks and benefits. Disclosing the statistical probability of injury and other possible outcomes might help, but it can also hinder the process.
After assessing the reasons for a patient’s unrealistic hopefulness in the face of clear understanding, a clinician may believe that significant harm will come to the patient if he or she does not acknowledge the seriousness of the illness.