Deborah M. Eng, MS, MA and Scott J. Schweikart, JD, MBE
A just culture perspective suggests that punitive responses to those who err should be reserved for those who have willfully and irremediably caused harm.
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.
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.
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.