AMA Journal of Ethics^®

A surgeon’s duty is to identify goals of care, including those about quality of life, from a patient’s perspective and to consider how to achieve them.

Guidance about sedation to unconsciousness and medically ineffective interventions can be applied to surgical palliation.

Dr Charles E. Binkley joins Ethics Talk to discuss his article: "How Should Surgeons Communicate About Palliative and Curative Intentions, Purposes, and Outcomes?"

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

Physicians new to a case might object to an established care plan. Practice variation, clinical momentum, and how value is assigned by different parties to acute care and comfort measures can each contribute to conflict in these cases.

Refusal of pediatric euthanasia can be considered iatrogenic insofar as it inadvertently prolongs patient suffering, but attitudes differ cross-culturally.

Moral distress can be reduced by approaching the patient-physician relationship with empathy and humility, which foster trust and good communication.

When ventilator support is being withdrawn from a dying child, responsive titration of sedative medications by the ICU team can relieve suffering without anesthetizing the child completely or hastening death.