Drs Michael Young, Robert Regenhardt, and Leonard Sokol join Ethics Talk to discuss their article, coauthored with Dr Thabele Leslie-Mazwi: "When Should Neuroendovascular Care for Patients With Acute Stroke Be Palliative?"

Lack of ethical, legal, and clinical consensus about best practice sometimes combines with a poor clinical evidence base.

Clinicians must avoid violating professional ethical principles and patients’ legal rights and they may not ever discriminate. So, what does that mean in practice?

For some patients whose survival is extended by disease-modifying interventions, little guidance about clinical and ethical complexities exist.

Guidance about sedation to unconsciousness and medically ineffective interventions can be applied to surgical palliation.

Patients leaving against medical advice draw attention to intersections of tort law, federal and state regulations, and clinical ethics.

Ethical dimensions of risk management are illuminated in AMA Code content on discharge planning.

Hospital lawyers’ practices shape risk management operations, influence clinicians’ morale, and affect patient care.

Psychiatric emergencies, coping stress reactions, and iatrogenic injuries are not responded to with the same vigor as acute medical decompensation. That needs to change.

The best interests of a pregnant psychotic patient can be served by determining her decision making capacity and using surrogate decision making if needed.