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.
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.
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.
Legacy patients are so-called because their opioid use behaviors express past, aggressive opioid prescribing by a clinician. Managing their pain and dependence justly is ethically complex.
AMA J Ethics. 2020;22(8):E651-657. doi:
10.1001/amajethics.2020.651.
A 3-step analgesic ladder was introduced in 1986 and needs change. Surgical interventions could reduce opioid use and motivate expansion of current pain management approaches.
AMA J Ethics. 2020;22(8):E695-701. doi:
10.1001/amajethics.2020.695.