Sometimes, life-saving treatments have serious negative consequences. This month, AMA Journal of Ethics digital editor Amelia Thomson-DeVeaux discusses strategies for communicating about iatrogenic outcomes with Dr. Robert Nelson, a senior pediatric ethicist with the Food and Drug Administration, with a particular focus on how to enlist parents as allies in high-stress pediatric cases.
AMA Journal of Ethics theme editor Renee Mao, a third-year medical student at the George Washington University School of Medicine and Health Sciences, interviewed Dr. Tarris Rosell, PhD, DMin, MDiv, about strategies for incorporating spiritual care into oncology.
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.
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.