Tag: ethics

Upvote Story 4
When we talk about triage, we could mean several things. We might mean the triage of patients arriving in the ED to assign clinical priority (because not everyone can be seen instantly); we might mean the triage of patients in a major incident or battlefield scenario; or we could mean the triage of patients to an appropriate level of care within the hospital. (E.g. Critical... Read More | Comment
Upvote Story 5
What do doctors and religious leaders have in common? At least a couple of big things: individuals in both professions engage with people at some of the most critical moments in their lives and require a high degree of empathy to truly succeed in all of their endeavors. Last year, I worked with the Rev. Professor Jane Shaw, at the time Stanford’s Dean of Religious... Read More | Comment
Upvote Story 6
The most important patient variables associated with the instigation of Life-sustaining Therapy (LST) limitation were acute admission, frailty, age, admission SOFA score and country. LST limitation was identified in 1356/5021 (27.2%) of patients: 15% had a withholding decision and 12.2% a withdrawal decision (including those with a previous withholding decision). Patients with LST limitation were older, more frail, more severely ill and less frequently electively... Read More | Comment
Upvote Story 14
Care that is inadequately respectful to patients and families in the setting of critical illness is prevalent but does not appear to be associated with clinical characteristics. The incidence of such emotional harms is nuanced, difficult to predict, and deserves further investigation. Of more than 1,500 respondents, 16.9% and 21.8% reported that the patient or the family member, respectively, received inadequate respect. This prospective cohort... Read More | Comment
Upvote Story 7
In critically ill patients, it is frequently challenging to identify who will benefit from admission to the intensive care unit and life-sustaining interventions when the chances of a meaningful outcome are unclear. In addition, the acute illness not only affects the patients but also family members or surrogates who often are overwhelmed and unable to make thoughtful decisions. In these circumstances, a time-limited trial (TLT)... Read More | Comment
Upvote Story 4
In nearly every intensive care unit (ICU) at every pediatric hospital across the country, physicians hold numerous care conferences with patients’ family members daily. Due to the challenging nature of many these conversations–covering anything from unexpected changes to care plans for critically ill children to whether it’s time to consider withdrawing life support–these talks tend to be highly emotional. That’s why physician empathy is especially... Read More | Comment
Upvote Story 14
Although the physician’s use and misuse of power have been discussed in the social sciences and in literature, they have never been explored in medical ethics until now. In this book, Dr. Howard Brody argues that the central task is not to reduce the physician’s power, as others have suggested, but to develop guidelines for its use, so that the doctor shares with the patient... Read More | Comment
Upvote Story 12
Children in precarious health present particular problems for healthcare professionals because of their intimate relation to their family, and because of the family’s need to provide major long-term source of support and to be actively involved in the decisions about their children’s care. This collection of cases and commentaries in pediatrics highlights the difficult ethical dilemmas that can arise during high-tech hospital care of children... Read More | Comment
Upvote Story 4
Medical professionals are expected to prioritize patient interests, and most patients trust physicians to act in their best interest. However, a single patient is never a physician’s sole concern. The competing interests of other patients, clinicians, family members, hospital administrators, regulators, insurers, and trainees are omnipresent. While prioritizing patient interests is always a struggle, it is especially challenging and important in the ICU setting where... Read More | Comment
Upvote Story 4
An admission to the intensive care unit (ICU) is often a traumatic experience for both patients and families. Although members of the critical care team are specially trained to provide care and treatment requiring close, constant observation, the environment can be overwhelming with machines, tubes, and equipment used in the care of the patient. With what feels like a barrage of requests for information about... Read More | Comment
Upvote Story 6
In this episode, we discuss the practice of respect in the ICU. Our guest is Samuel M. Brown, MD, MS, a practicing intensivist and Director of the Center for Humanizing Critical Care at Intermountain Medical Center in Murray, Utah. Dr. Brown holds an academic appointment as Associate Professor of Medicine at the University Of Utah School Of Medicine, Murray UT. He is a prolific investigator... Read More | Comment
Upvote Story 5
The educational and social milieu of medical learning environments is a complex system of influences. Role models across peer relationships and the hierarchy of medicine contribute to the formation of professional identity, behaviors, and attitudes of future physicians. The best solutions to the influence of the hidden curriculum will uncover it, integrate its positive aspects into the formal curriculum, and lead to development of approaches... Read More | Comment
Upvote Story 21
In our current medical culture, the old and the ill are put on what she terms the End-of-Life Conveyor belt. They are intubated, catheterized, and even shelved away in care facilities to suffer their final days alone, confused, and often in pain. In her work Zitter has learned what patients fear more than death itself: the prospect of dying badly. She builds bridges between patients... Read More | Comment
Upvote Story 7
I overheard a colleague admit an 84-year-old woman to the hospital from the emergency department for a sizable mass in her uterus — no doubt, cancerous. I pictured a frail woman who’d been suffering for a while and was afraid to tell anyone about it, fearing the worst. Like most, she preferred to ignore it rather than have others tell her what to do. Having... Read More | Comment