When patients are unable to express their wishes and do not have surrogates or advance directives, which and whose values should inform decision making for them? We discuss ethical complexities of caring for unrepresented patients.
Ruth L. Ackah, MD, Rohini R. Sigireddi, and Bhamidipati V. R. Murthy, MD
Although undocumented immigrants contribute to the pool of available organs and to the US tax base, they are not eligible for organ transplantation in most US states.
AMA J Ethics. 2019;21(1):E17-25. doi:
10.1001/amajethics.2019.17.
A guardian’s request to sterilize a woman with intellectual disabilities is not ethically justifiable unless the woman assents and it is to her benefit.
AMA J Ethics. 2016;18(4):365-372. doi:
10.1001/journalofethics.2016.18.4.ecas2-1604.
Efrat Lelkes, MD, Angira Patel, MD, MPH, Anna Joong, MD, and Jeffrey G. Gossett, MD
Current policy requires separate informed consent for some Public Health Service increased-risk donors, and this can make shared decision making harder.
AMA J Ethics. 2020;22(5):E401-407. doi:
10.1001/amajethics.2020.401.
Shared decision making honors patient autonomy, particularly for preference-sensitive care decisions and even when patients have impaired decision-making capacity.
AMA J Ethics. 2020;22(5):E358-364. doi:
10.1001/amajethics.2020.358.
William F. Parker, MD, MS and Marshall H. Chin, MD, MPH
Given organ scarcity, transplantation programs state that patient promises of compliance cannot be taken at face value, excluding candidates who are deemed untrustworthy.
AMA J Ethics. 2020;22(5):E408-415. doi:
10.1001/amajethics.2020.408.
Frances Grimstad, MD, MS and Elizabeth Boskey, PhD, MPH, MSSW, LICSW
Gender-affirming surgery for teens is growing as a field. Norms about who should be involved, to what extent, and for which health decisions are still evolving.
AMA J Ethics. 2020;22(5):E452-457. doi:
10.1001/amajethics.2020.452.
Drs Katrina Bramstedt and Ana Iltis discuss the development of QoL assessment tools to help patient-subjects considering reconstructive transplantation.