Dr Rajesh R. Tampi joins Ethics Talk to discuss his article, coauthored with Drs Aarti Gupta and Iqbal Ahmed: “Why Does the US Overly Rely on International Medical Graduates in Its Geriatric Psychiatric Workforce?”
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.
The U. S. health care system encourages patients to take more responsibility for their own treatment decisions and expects their doctors to cooperate in that effort. But the guidelines for exercising that responsibility remain very murky indeed.
Fibromyalgia, with no positive tests, is a “foreigner” in the medical landscape. Medicine looks for signs of pathology, changes in the structure or function of organs. The mantra of physicians facing patients with fibromyalgia: “Your tests are normal.”
Katrina A. Bramstedt, PhD and Francis L. Delmonico, MD
Transplant centers cannot regulate how people establish relationships, but when a donor-recipient pair comes together through Internet solicitation, the center must assess the donor’s motivations carefully.
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.