A lack of consensus guidelines or a belief that current evidence does not support such guidelines might be justified if a clinician expresses a commitment to patient-centered care and shared decision making.
Parents’ false beliefs can be engaged respectfully to motivate deliberations about shared values and goals, but refusal of clinically indicated treatment could warrant reporting.
Annette Hanson, MD, Ron Pies, MD, and Mark Komrad, MD
Authors respond to “How Should Physicians Care for Dying Patients with Amyotrophic Lateral Sclerosis?” by arguing that patients’ motives for accessing death with dignity laws should be thoroughly explored and that temporarily limiting patient autonomy can promote well-being at the end of life.
Alexander Craig, MPhil and Elizabeth Dzeng, MD, PhD, MPH
Responding to “Added Points of Concern about Caring for Dying Patients,” authors argue that physicians’ refusal to prescribe lethal drugs in accordance with states’ death with dignity laws could damage patient-physician relationships and harm patients.
Therapeutic misconception—a false belief that individuals will benefit from participating in research—can bias informed consent. Ethics consultants can help by engaging participants’ and researchers’ understandings of risks and benefits and by asking good questions about the influences of researchers’ enthusiasm.
When symptoms of polypharmacy are consistent with those of difficult-to-diagnose disorders, reliable determinations about which drugs are necessary is critical.
Regularly scheduled dialysis is not standard of care for most undocumented immigrants in the United States, so preventative care, and advocacy for it, is needed.
Haley Moulton, Benjamin Moulton, JD, MPH, Tim Lahey, MD, MMSc, and Glyn Elwyn, MD, PhD, MSc
Shared decision making in research informed consent conversations is complex due to diverse and potentially divergent interests of investigators and patient-subjects.