journal
MENU ▼
Read by QxMD icon Read
search

AMA Journal of Ethics

journal
https://www.readbyqxmd.com/read/28430575/nested-tensions-in-care
#1
Merel Visse
This project presents research-based art works that inquire into the tensions in everyday life from an ethical viewpoint of care, which sees people as embedded, "nested" in care-based relationships. Trust is the glue that holds these "nests" together. Care is the air that lifts them up, but tensions exist as well-between dependency and autonomy, vulnerability and strength, for example. The pull of these ideas exist in a kind of "check" and run through our relations and being.
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28430574/how-navigating-uncertainty-motivates-trust-in-medicine
#2
Jonathan B Imber
Three significant factors in the shaping of modern medicine contribute to broad perceptions about trust in the patient-physician relationship: moral, professional, and epidemiological uncertainty. Trusting a physician depends first on trusting a person, then trusting a person's skills and training, and finally trusting the science that underwrites those skills. This essay, in part based on my book, Trusting Doctors: The Decline of Moral Authority in American Medicine (Princeton University Press, 2008), will address the forms of uncertainty that contribute to the nature of difficult encounters in the patient-physician relationship...
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28430573/roles-of-physicians-and-health-care-systems-in-difficult-clinical-encounters
#3
Elizabeth S Goldsmith, Erin E Krebs
Physicians are, by definition, contributing partners in "difficult" patient-physician encounters. Although research on relevant physician qualities is limited, common themes mirror the more extensive literature on physician burnout. Focusing on primary care, we discuss physician-level factors in difficult encounters related to psychosocial attitudes and self-awareness, communication skills, and practice environments. Potential approaches to mitigating these factors include changes to medical training, such as structured peer case discussion groups and communication skills development, and changes to workplace environments, such as integrated mental health...
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28430572/lessons-about-so-called-difficult-patients-from-the-uk-controversy-over-patient-access-to-electronic-health-records
#4
Federica Lucivero
Increasing numbers of patients have direct access to their electronic health records (EHRs). Proponents of direct access argue that it empowers patients by making them more informed and offering them more control over their health and care. According to some proponents of patients' access to EHRs, clinicians' concerns about potential negative implications are grounded in a form of paternalism that protects clinicians' authority. This paper draws upon narratives from patients in the United Kingdom (UK) who have access to their EHRs and suggests strategies for moving beyond these controversies between proponents and critics of the system...
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28430571/forty-years-since-taking-care-of-the-hateful-patient
#5
Richard B Gunderman, Peter R Gunderman
Using the word "hateful" is not the only option in describing patients who induce in clinicians feelings of dread. We suggest an alternative approach to the language of hate, one that seeks dignity and perhaps even a divine spark in every patient.
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28430570/repairing-difficult-patient-clinician-relationships
#6
Denise M Dudzinski, Carrol Alvarez
Using a case example, we offer guidance for improving "difficult" clinician-patient relationships. These relationships may be repaired by acknowledging a clinician's part in conflict, empathizing with patients, identifying a patient's skill deficits, and employing communication and engagement techniques used by mental health professionals. Clinicians will inevitably take on more of the work of repairing damaged relationships, but doing so improves the odds of these patients receiving the help they need.
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28430569/courage-and-compassion-virtues-in-caring-for-so-called-difficult-patients
#7
Michael Hawking, Farr A Curlin, John D Yoon
What, if anything, can medical ethics offer to assist in the care of the "difficult" patient? We begin with a discussion of virtue theory and its application to medical ethics. We conceptualize the "difficult" patient as an example of a "moral stress test" that especially challenges the physician's character, requiring the good physician to display the virtues of courage and compassion. We then consider two clinical vignettes to flesh out how these virtues might come into play in the care of "difficult" patients, and we conclude with a brief proposal for how medical educators might cultivate these essential character traits in physicians-in-training...
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28430568/reflection-based-learning-for-professional-ethical-formation
#8
William T Branch, Maura George
One way practitioners learn ethics is by reflecting on experience. They may reflect in the moment (reflection-in-action) or afterwards (reflection-on-action). We illustrate how a teaching clinician may transform relationships with patients and teach person-centered care through reflective learning. We discuss reflective learning pedagogies and present two case examples of our preferred method, guided group reflection using narratives. This method fosters moral development alongside professional identity formation in students and advanced learners...
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28430567/how-should-clinicians-respond-to-medical-requests-from-clinician-family-members-of-patients
#9
Andrew Thurston
In the medical profession, receiving a request for medical management from a colleague is a routine experience. However, when the colleague is a family member of a patient and the desired or requested medical intervention is not medically indicated in the attending physician's view, the situation becomes more complicated. Ethical issues include respect for patient autonomy and social justice as well as nonmaleficence. Furthermore, interpersonal and professional relationships may be tested in this situation...
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28430566/how-should-physicians-respond-when-patients-distrust-them-because-of-their-gender
#10
Monica Peek, Bernard Lo, Alicia Fernandez
There are many reasons why gender-concordant care benefits patients and is requested by them. For training hospitals, however, such requests present challenges as well as opportunities in providing patient-centered care. Responding to a case in which a female patient who is having a routine exam refuses care from a male medical student, we discuss ethical principles involved in gender-concordant care requests, when it is appropriate to question such requests, and a team-based approach to responding to them.
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28430565/do-physicians-have-an-ethical-duty-to-repair-relationships-with-so-called-difficult-patients
#11
Micah Johnson
This essay argues that physicians hold primary ethical responsibility for repairing damaged patient-physician relationships. The first section establishes that the patient-physician relationship has an important influence on patient health and argues that physicians' duty to treat should be understood as including a responsibility to repair broken relationships, regardless of which party was "responsible" for the initial tension. The second section argues that the person with more power to repair the relationship also has more responsibility to do so and considers the moral psychology of pain as foundational to conceiving the patient in this case as especially vulnerable and disempowered...
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28323613/correction-to-the-case-of-dr-oz-ethics-evidence-and-does-professional-self-regulation-work
#12
Audiey C Kao
No abstract text is available yet for this article.
March 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28323612/from-particularities-to-context-refining-our-thinking-on-illness-narratives
#13
Annie Le, Kara Miller, Juliet McMullin
This paper examines how illness narratives are used in medical education and their implications for clinicians' thinking and care of patients. Ideally, collecting and reading illness narratives can enhance clinicians' sensitivity and contextual thinking. And yet these narratives have become part of institutionalizing cultural competency requirements in ways that tend to favor standardization. Stereotyping and reductionistic thinking can result from these pedagogic approaches and obscure structural inequities...
March 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28323611/the-role-of-universal-health-literacy-precautions-in-minimizing-medspeak-and-promoting-shared-decision-making
#14
Lara Killian, Margo Coletti
Shared decision making (SDM), a collaborative process whereby patients and professionals make health care decisions together, is a cornerstone of ethical patient care. The patient-clinician communication necessary to achieve SDM depends on many factors, not the least of which is a shared language (sometimes with the aid of a medical interpreter). However, even when a patient and clinician are speaking the same mother tongue, the use of medical jargon can pose a large and unnecessary barrier. This article discusses how health care professionals can use "universal health literacy precautions" as a legal, practical, and ethical means to enhance SDM and improve health care outcomes...
March 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28323610/strategies-for-acing-the-fundamentals-and-mitigating-legal-and-ethical-consequences-of-poor-physician-patient-communication
#15
MaryKatherine Brueck, Angelique M Salib
This article explores how the absence of effective verbal and nonverbal communication in the physician-patient encounter can lead to poor outcomes for patients and physicians alike. The article discusses legal and ethical topics physicians should consider during a medical encounter and provides educational and practical suggestions for improving effective communication between physicians and their patients.
March 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28323609/language-structure-and-reuse-in-the-electronic-health-record
#16
Angus Roberts
Medical language is at the heart of the electronic health record (EHR), with up to 70 percent of the information in that record being recorded in the natural language, free-text portion. In moving from paper medical records to EHRs, we have opened up opportunities for the reuse of this clinical information through automated search and analysis. Natural language, however, is challenging for computational methods. This paper examines the tension between the nuanced, qualitative nature of medical language and the logical, structured nature of computation as well as the way in which these have interacted with each other through the medium of the EHR...
March 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28323608/from-doctors-stories-to-doctors-stories-and-back-again
#17
Marcia Day Childress
Stories have always been central to medicine, but during the twentieth century bioscience all but eclipsed narrative's presence in medical practice. In Doctors' Stories, published in 1991, Kathryn Montgomery excavated medicine's narrative foundations and functions to reveal new possibilities for how to conceive and characterize medicine. Physicians' engagement with stories has since flourished, especially through the narrative medicine movement, although in the twenty-first century this has been challenged by the health care industry's business-minded and data-driven clinical systems...
March 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28323607/language-based-inequity-in-health-care-who-is-the-poor-historian
#18
Alexander R Green, Chijioke Nze
Patients with limited English proficiency (LEP) are among the most vulnerable populations. They experience high rates of medical errors with worse clinical outcomes than English-proficient patients and receive lower quality of care by other metrics. However, we have yet to take the issue of linguistic inequities seriously in the medical system and in medical education, tacitly accepting that substandard care is either unavoidable or not worth the cost to address. We argue that we have a moral imperative to provide high-quality care to patients with LEP and to teach our medical trainees that such care is both expected and feasible...
March 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28323606/when-and-how-should-clinicians-share-details-from-a-health-record-with-patients-with-mental-illness
#19
Robyn P Thom, Helen M Farrell
Stigma associated with mental illness-a public health crisis-is perpetuated by the language used to describe and document it. Psychiatric pathology and how it can be perceived among clinicians contribute to the marginalization of patients, which exacerbates their vulnerability. Clinical documentation of mental illness has long been mired in pejorative language that perpetuates negative assumptions about those with mental illness. Although patients have the legal right to view their health record, sharing mental health notes with patients remains a sensitive issue, largely due to clinicians' fears that review of this content might cause harm, specifically psychiatric destabilization...
March 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28323605/clinicians-obligations-to-use-qualified-medical-interpreters-when-caring-for-patients-with-limited-english-proficiency
#20
Gaurab Basu, Vonessa Phillips Costa, Priyank Jain
Access to language services is a required and foundational component of care for patients with limited English proficiency (LEP). National standards for medical interpreting set by the US Department of Health and Human Services and by the National Council on Interpreting in Health Care establish the role of qualified medical interpreters in the provision of care in the United States. In the vignette, the attending physician infringes upon the patient's right to appropriate language services and renders unethical care...
March 1, 2017: AMA Journal of Ethics
journal
journal
49981
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"