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.
Dichotomies, such as reconstructive vs aesthetic surgery and medical vs cosmetic dermatology, can distort meanings of surgical procedures. This can compromise the value of procedures themselves and practices for their reimbursement.
AMA J Ethics. 2018;20(12):E1188-1194. doi:
10.1001/amajethics.2018.1188.
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.
This article considers that benefits of using humor in clinical settings come with risks of diminishing therapeutic capacity in patient-clinician relationships.
AMA J Ethics. 2020;22(7):E576-582. doi:
10.1001/amajethics.2020.576.