Given full information about the risks of long-term opioid therapy, patients often see the value of exploring other options rather than thinking their physicians are reluctant to prescribe narcotics for fear of litigation or regulatory action.
AMA J Ethics. 2015;17(3):202-208. doi:
10.1001/journalofethics.2015.17.3.ecas1-1503.
Oliver Schirokauer, PhD, MD, Thomas A. Tallman, DO, MMM, Leah Jeunnette, PhD, Despina Mavrakis, MBA, and Monica L. Gerrek, PhD
An educational initiative is described in which medical and bioethics students observe health care in an urban jail for two days and reflect on their learning.
AMA J Ethics. 2017;19(9):845-853. doi:
10.1001/journalofethics.2017.19.9.peer1-1709.
Dr Brent M. Kious joins Ethics Talk to discuss his article, coauthored with Dr Ryan H. Nelson: “Does It Matter Whether a Psychiatric Intervention Is ‘Palliative’?”
Dr Cynthia Geppert joins Ethics Talk to discuss how teaching health professions students and trainees about palliative psychiatry reinvigorates core philosophy of medicine investigations into what health care is for.
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.
One strategy is to determine “triggers” that alert the primary clinician that the patient has a high symptom burden or difficulty coping with the diagnosis, prognosis, or treatment plans and should be offered palliative care services.