Assuming rigid control over patients’ health care and subjecting them to strict regimens without offering them a choice in the matter is frank paternalism. Moreover, proceeding with an invasive test without obtaining proper informed consent is malpractice.
Society values both the appropriate use of new technological and management innovations and the maintenance of a strong personal and therapeutic relationship between patients and physicians. The medical-home model may be able to accomplish both.
In clinical settings, chaplains are key communicators who help mediate between patients, families, and the medical team. This month on Ethics Talk, we explore how chaplains help patients and families articulate their goals and navigate logistical and emotional challenges that arise in the hospital.
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.
Palliative psychiatry can facilitate compassionate resolution of ethical conflicts in end-of-life care decision making with persons with substance use disorders.
AMA J Ethics. 2023;25(9):E678-683. doi:
10.1001/amajethics.2023.678.
Given full information about the risks of long-term opioid therapy, patients often see the value of exploring other options rather than thinking their physicians are reluctant to prescribe narcotics for fear of litigation or regulatory action.
AMA J Ethics. 2015;17(3):202-208. doi:
10.1001/journalofethics.2015.17.3.ecas1-1503.
Oliver Schirokauer, PhD, MD, Thomas A. Tallman, DO, MMM, Leah Jeunnette, PhD, Despina Mavrakis, MBA, and Monica L. Gerrek, PhD
An educational initiative is described in which medical and bioethics students observe health care in an urban jail for two days and reflect on their learning.
AMA J Ethics. 2017;19(9):845-853. doi:
10.1001/journalofethics.2017.19.9.peer1-1709.
Dr Brent M. Kious joins Ethics Talk to discuss his article, coauthored with Dr Ryan H. Nelson: “Does It Matter Whether a Psychiatric Intervention Is ‘Palliative’?”