This article examines conceptual limitations of extant accounts of palliative psychiatry, with a focus on obligations to distinguish among and clearly formulate goals of care.
AMA J Ethics. 2023;25(9):E710-717. doi:
10.1001/amajethics.2023.710.
Dr Anna L. Westermair joins Ethics Talk to discuss her article, coauthored with Dr Manuel Trachsel: “Moral Intuitions About Futility as Prompts for Evaluating Goals in Mental Health Care.”
Marc M. Beuttler, MA, Kara N. Goldman, MD, and Jamie A. Grifo, MD, PhD
Respect for informed, autonomous decision making demands that useful, if anxiety-provoking, information about age-related decline in fertility not be withheld from women.
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.