Undocumented patients in the United States with end-stage renal disease receive “compassionate” dialysis. Such patients oscillate between being marginally well and “ill enough” to receive dialysis while clinicians wrestle with complicity in a system that both offers and withholds life-saving therapy.
AMA J Ethics. 2018;20(8):E778-779. doi:
10.1001/amajethics.2018.778.
An undercurrent in all debates about allocation of health care resources to the poor is the matter of access to and coverage of health care for immigrants, particularly low-income and undocumented ones.
Michael Farias, MD, MS, MBA and Rahul H. Rathod, MD
A distinguishing feature of a SCAMP is its ability to capture knowledge-based diversions from a recommended pathway and to “learn” from such individualized patient management.
Industrialized nations could benefit from strategies emerging in developing nations such as respectful collaboration between traditional out-of-hospital birthing practices and maternity units in partnering hospitals.
Protecting one’s moral integrity may require a conscience clause that protects positive conscience claims by permitting individuals to perform actions that are otherwise prohibited by legal or institutional rules.
The causes of many health behaviors are deeply rooted in our culture, and using a counseling model that assumes individual control and responsibility for these behaviors can cause patients to feel hectored instead of helped.
Margaret Little, PhD and Anne Drapkin Lyerly, MA, MD
Society is best served by an approach to conscience that combines a progressive understanding of patients’ needs, a nuanced determination of when those needs translate into claims, and a limited role for conscientious refusal.