When the health care industry came under the environmental microscope, the daily work of treating patients was discovered to be highly wasteful of natural and financial resources.
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.
Jennifer Aldrich, MD, Jessica Kant, MSW, LICSW, MPH, and Eric Gramszlo
Estelle v Gamble (1976) reiterates that the 8th Amendment to the US Constitution requires adequate care to be offered to all people who are incarcerated.
AMA J Ethics. 2023; 25(6):E407-413. doi:
10.1001/amajethics.2023.407.
Dr Jennifer Aldrich joins Ethics Talk to discuss her article, coauthored with Jessica Kant and Eric Gramszlo: “Gender-Affirming Care, Incarceration, and the Eighth Amendment.”
Dr Azziza Bankole joins Ethics Talk to discuss her article, coauthored with Drs Darlon Jan and Mamta Sapra: “What Should Be the Scope of Long-Term Care Organizations’ Obligations to Offer Culturally and Linguistically Appropriate Services to Patients?”
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.