AMA Journal of Ethics

Dr Laura Guidry-Grimes helps us consider whether and which decisions can be shared with people experiencing mental illnesses.

Shared decision making is practically difficult to implement in mental health practice but remains an ethical ideal for motivating therapeutic capacity.

Shared decision making is complex with patients who are adolescents, whose relational autonomy is still emerging.

A UPAC is an alternative to engaging a guardianship court appointment process or to using physicians or ethics committees as decision makers.

When patients are unable to express their wishes and do not have surrogates or advance directives, which and whose values should inform decision making for them? We discuss ethical complexities of caring for unrepresented patients.

Despite challenges of decision making for unrepresented patients, few laws or policy statements offer solutions. This article offers 5 key things to do.

A deliberative approach to responding to needs and vulnerabilities of unrepresented patients can help make the most of having too little information.

Physicians, committees, and guardians all make decisions for unrepresented patients in the US. This article considers a “tiered” approach as an alternative.

End-stage heart failure patients can experience depression along with their chronic illness. Multidisciplinary responses are critical.

Patients have a right to decline or withdraw LVADs. Informed consent and shared decision making is not easy, however, with treatments that are high risk, high reward.