AMA Journal of Ethics

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.

When patients cannot give informed consent or refusal for antipsychotic medication, physicians must meet specific criteria to justify temporarily withholding a diagnosis.

Perhaps machine learning systems trained on patients’ electronic health records and social media footprints could be used as decision aids when patients lack capacity or face overwhelming decisions.

A patient’s refusal of tracheostomy during an anticipated difficult intubation prompts critical questions about how to best express respect for a pediatric patient’s autonomy and whether and when deviation from standard of care is clinically and ethically appropriate.