Caregivers often think that so-called “frequent-flyer” patients are at fault for their poor medical outcomes. In many such cases, though, unaddressed psychosocial issues are the root of the patients’ repeat visits to the emergency department.
The question is whether the medi-spa is a consumer-driven, profit-motivated business that happens to fall under the purview of medical practice or a legitimate and integral part of the health care system? Does it fulfill consumers’ desires or relieve suffering and promote wellness?
Is our generation of physicians somehow “weaker” because we’d rather not spend our entire lives at the office? Physicians who trained and practiced under more grueling conditions wonder how we expect to be competent physicians if we don’t work at it?
Katherine Gentry, MD, MA and Aaron Wightman, MD, MA
A patient’s refusal of tracheostomy during an anticipated difficult intubation prompts critical questions about how to best express respect for a pediatric patient’s autonomy and whether and when deviation from standard of care is clinically and ethically appropriate.
AMA J Ethics. 2018; 20(8):E683-689. doi:
10.1001/amajethics.2018.683.
Alexander Craig, MPhil and Elizabeth Dzeng, MD, PhD, MPH
Eliciting the patient’s motives and goals and helping the patient and her loved ones explore alternatives are essential to maintaining trusting relationships and open communication.
AMA J Ethics. 2018; 20(8):E690-698. doi:
10.1001/amajethics.2018.690.
Peter T. Hetzler III and Lydia S. Dugdale, MD, MAR
Countering overmedicalization of death requires acknowledging that dying patients are living patients. It also requires persistent focus on health and wholeness, especially at the end of life, and a solid interdisciplinary approach to supporting dying patients.
AMA J Ethics. 2018; 20(8):E766-773. doi:
10.1001/amajethics.2018.766.
Targeted dosing to treat pediatric inflammatory bowel disease is challenging because dosing guidelines are based on data gathered from adult subjects of clinical trials. Patients’ families and health care organizations also incur high costs and must try to balance potential benefits against risks of ongoing monitoring.
AMA J Ethics. 2018; 20(9):E841-848. doi:
10.1001/amajethics.2018.841.
Dr Vivek H. Murthy joins Ethics Talk to discuss loneliness as a public health threat and the connection between loneliness, public health responsiveness, and the health of our democracy.