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Is there clear and convincing evidence that an individual has no pain that would justify a prescription analgesic and is, therefore, seeking medication solely because of an addictive disorder, recreational use, or with the intent of diverting it to others?
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If a provider tells patients they might have been exposed to a blood-borne pathogen when they actually weren't, then the patients worried needlessly when there was no actual health risk.
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Access to the electronic health record (EHR) of an individual patient as well as what the person looking at the record does with that information remain concerns for all professionals and institutions involved in patient care.
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At the start of leading an 18-month pilot project to explore organ donation for patients who died in the emergency department (ED) at University of Pittsburgh Medical Center, Clifton W. Callaway, MD, believed the team was "creating, in reality, what the general public already thought existed."
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The evolution of "transplant tourism" drives home the point that people are willing to go to extreme lengths to procure an organ, according to Leslie M. Whetstine, PhD, an assistant professor of philosophy at Walsh University in North Canton, OH. "Despite the fact that the public overwhelmingly supports organ donation in this country, our actions unfortunately do not reflect that sentiment," she says.
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The history of cardiac arrest as an indication for resuscitation is "loaded with implications for current standards of care," says Daniel Brauner, MD, associate professor of medicine at the University of Chicago. At one point in time, resuscitation was used only in very limited instances, he explains.
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It's a "tremendous victory to have something approaching universal access" as a result of the Patient Protection and Affordable Care Act, but the resulting increase in underinsured patients will pose ethical challenges for providers, according to Joseph J. Fins, MD, MACP, chief of the Division of Medical Ethics at Weill Cornell Medical College and director of medical ethics at New York Presbyterian Hospital-Weill Cornell Center in New York City.
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Prescribing potentially addictive medications "is often a very challenging situation for physicians," says David A. Fleming, MD, MA, FACP, professor and chairman of the Department of Internal Medicine and director of the Center for Health Ethics at University of Missouri in Columbia.
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Linking payment to patient satisfaction could have a profound impact on the doctor-patient relationship, argues James N. Kirkpatrick, MD, an assistant professor of medicine at the Hospital of the University of Pennsylvania who is affiliated with the University of Pennsylvania Department of Medical Ethics and Health Policy.
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Approximately one in five (22%) out of 608 critical care physicians surveyed reported always providing surrogates of critically ill adult patients with a recommendation about limiting life support, while one in 10 (11%) reported rarely or never doing so, according to a just-published study.1 Surrogates' desires for recommendations and physicians' agreements with surrogates' likely decisions may influence whether recommendations are provided.
