Using the patient’s worldview to challenge his or her decision and establish a treatment plan—implying the view is shared by the physician when it is not—could be seen as manipulative and deceptive.
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 greatest pressure to resuscitate the extremely low-birth-weight infant often results from successful marketing efforts that lead families to expect that their premature infants will be cute and healthy.
Physicians new to a case might object to an established care plan. Practice variation, clinical momentum, and how value is assigned by different parties to acute care and comfort measures can each contribute to conflict in these cases.
AMA J Ethics. 2018; 20(8):E699-707. doi:
10.1001/amajethics.2018.699.
Tracy Shamas, MSN, APRN and Sarah Gillespie-Heyman, MSN, APRN
Veterans at the end of life have special needs due to posttraumatic stress disorder, environmental exposures, and the influence of military culture on their values. Those who die outside the Veterans Affairs health care system, however, can be at increased risk for receiving outpatient palliative care that is not sensitive to these factors.
AMA J Ethics. 2018; 20(8):E787-792. doi:
10.1001/amajethics.2018.787.
Joel A. DeLisa, MD, MS and Jacob Jay Lindenthal, PhD, DrPH
Research on experiences of practicing physicians who have disabilities could help medical schools counsel applicants and increase enrollment among students with disabilities. This can ultimately improve care for patients with disabilities.
AMA J Ethics. 2016; 18(10):1003-1009. doi:
10.1001/journalofethics.2016.18.10.stas1-1610.
Jonathan Treem, MD, Joel Yager, MD, and Jennifer L. Gaudiani, MD, CEDS-S
Some individuals with severe and enduring anorexia nervosa experience dramatically degraded quality of life in the face of refractory illness and compulsory treatment.
AMA J Ethics. 2023; 25(9):E703-709. doi:
10.1001/amajethics.2023.703.
This article examines conceptual limitations of extant accounts of palliative psychiatry, with a focus on obligations to distinguish among and clearly formulate goals of care.
AMA J Ethics. 2023; 25(9):E710-717. doi:
10.1001/amajethics.2023.710.
Dr Anna L. Westermair joins Ethics Talk to discuss her article, coauthored with Dr Manuel Trachsel: “Moral Intuitions About Futility as Prompts for Evaluating Goals in Mental Health Care.”