Dr Matthew C. Bobel joins Ethics Talk to discuss his article, coauthored with Dr Robert K. Cleary: “How Should Risk Be Communicated to Patients When Developing Resident Surgeon Robotic Skills?”
A judicious approach to autism would be to replace a “disability” or “illness” paradigm with a “diversity” perspective that takes into account both strengths and weaknesses and the idea that variation can be positive in and of itself.
AMA J Ethics. 2015;17(4):348-352. doi:
10.1001/journalofethics.2015.17.4.msoc1-1504.
In treating children with autism, physicians should reframe the common dynamic in which the family wants medication that the doctor is withholding to focus instead on the family’s and physician’s share goal—the patient’s well-being.
AMA J Ethics. 2015;17(4):299-304. doi:
10.1001/journalofethics.2015.17.4.ecas1-1504.
The neurodiversity movement challenges us to rethink autism through the lens of human diversity, valuing diversity in neurobiologic development as we would value it in gender, race, ethnicity, religion, or sexual orientation.
The physician must consider the potential benefits of the new procedure and then determine, through discussion with the patient, what value the patient places on those specific benefits.
In treating children with autism, physicians should focus on involving parents in a shared decision making partnership and seeking safe, evidence-based, and medically and cost-effective treatments.
AMA J Ethics. 2015;17(4):310-317. doi:
10.1001/journalofethics.2015.17.4.ecas3-1504.
Although now discredited, the idea that mothers’ behavior is responsible for autism lives on in the social pressure that mothers feel to save their autistic children, at a cost to both the self-blaming parents and people with autism.
AMA J Ethics. 2015;17(4):353-358. doi:
10.1001/journalofethics.2015.17.4.mhst1-1504.
Evaluation of an autism curriculum for pediatric residents yielded significant short-term gains in residents’ objective and self-assessed knowledge of autism spectrum disorder diagnosis and treatment.
AMA J Ethics. 2015;17(4):318-322. doi:
10.1001/journalofethics.2015.17.4.medu1-1504.
Minors, including those with autism, have the right in certain states to make decisions about their own medical care provided they meet certain criteria. Even in cases in which the “mature minor exception” does not apply, physicians should actively engage patients in discussion of their treatment.
AMA J Ethics. 2015;17(4):305-309. doi:
10.1001/journalofethics.2015.17.4.ecas2-1504.
The harms of communicating autism risk can be avoided by helping families to understand risk and to distinguish between poor and good sources of scientific information, which should take families’ interests into account.
AMA J Ethics. 2015;17(4):323-327. doi:
10.1001/journalofethics.2015.17.4.nlit1-1504.