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How Should IUD Placement Pain Be Described and Managed? 如何描述和管理宫内节育器放置疼痛？
AMA journal of ethics Pub Date : 2025-02-01 DOI: 10.1001/amajethics.2025.72
Veronica Hutchison, Eve Espey
{"title":"How Should IUD Placement Pain Be Described and Managed?","authors":"Veronica Hutchison, Eve Espey","doi":"10.1001/amajethics.2025.72","DOIUrl":"10.1001/amajethics.2025.72","url":null,"abstract":"<p><p>This commentary on a case considers recent publicity about pain with intrauterine device insertion and clinically and ethically relevant factors that influence pain and pain management strategies for this effective contraceptive method.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 2","pages":"E72-78"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Abortion in the Nineteenth Century Through the Lens of Ann Lohman. 安·洛曼镜头下的19世纪堕胎。
AMA journal of ethics Pub Date : 2025-02-01 DOI: 10.1001/amajethics.2025.149
Suzanne Minor, Arianna Tapia, Sarah E Stumbar
{"title":"Abortion in the Nineteenth Century Through the Lens of Ann Lohman.","authors":"Suzanne Minor, Arianna Tapia, Sarah E Stumbar","doi":"10.1001/amajethics.2025.149","DOIUrl":"10.1001/amajethics.2025.149","url":null,"abstract":"<p><p>Ann Lohman, a midwife in the 1800s also known as Madame Restell, deserves our attention following the US Supreme Court decision in Dobbs v Jackson Women's Health Organization in June 2022. As abortion regulations change, it is important that health care communities learn from past experiences. This article examines the historical context in which Lohman practiced and draws out key lessons to be applied today.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 2","pages":"E149-158"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How Should Intensity and Duration of Pain Inform Standard of Care for Pain Management in Non-Labor and Delivery OB/GYN Procedures? 疼痛的强度和持续时间如何告知非分娩和分娩过程中疼痛管理的护理标准？
AMA journal of ethics Pub Date : 2025-02-01 DOI: 10.1001/amajethics.2025.98
Lisa Bayer, Evelyn Ainsley McWilliams
{"title":"How Should Intensity and Duration of Pain Inform Standard of Care for Pain Management in Non-Labor and Delivery OB/GYN Procedures?","authors":"Lisa Bayer, Evelyn Ainsley McWilliams","doi":"10.1001/amajethics.2025.98","DOIUrl":"10.1001/amajethics.2025.98","url":null,"abstract":"<p><p>Pain experienced during gynecologic exams and procedures is dismissed, not recognized, and undertreated by some clinicians. This article considers how duration and intensity of pain experienced can be used to direct care. This article also discusses possible consequences of undertreating pain and suggests pain management standards that can be used by clinicians to provide individualized, trauma-informed care and promote shared decision-making.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 2","pages":"E98-103"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How We Lie About Pain. 我们如何对疼痛撒谎。
AMA journal of ethics Pub Date : 2025-02-01 DOI: 10.1001/amajethics.2025.69
Amy Lorber, Andrew Lynch
{"title":"How We Lie About Pain.","authors":"Amy Lorber, Andrew Lynch","doi":"10.1001/amajethics.2025.69","DOIUrl":"https://doi.org/10.1001/amajethics.2025.69","url":null,"abstract":"","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 2","pages":"E69-71"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How Should Gynecologists Respond in the Moment to Physiological, Historical, and Psychosocial Features of Patients' Pain? 妇科医生应该如何应对患者疼痛的生理、历史和社会心理特征？
AMA journal of ethics Pub Date : 2025-02-01 DOI: 10.1001/amajethics.2025.129
Emma Lantos, Marit Pearlman Shapiro, Brian T Nguyen
{"title":"How Should Gynecologists Respond in the Moment to Physiological, Historical, and Psychosocial Features of Patients' Pain?","authors":"Emma Lantos, Marit Pearlman Shapiro, Brian T Nguyen","doi":"10.1001/amajethics.2025.129","DOIUrl":"10.1001/amajethics.2025.129","url":null,"abstract":"<p><p>Patients should receive appropriate pain relief when undergoing procedures. This article canvases historical and sociological underpinnings of how clinicians have responded and should respond in the moment to patients' pain during elective gynecologic procedures, such as intrauterine device placement and first-trimester abortion. This article then considers evidence-based techniques for responding to patients' pain expressions and experiences during such procedures. Finally, this article addresses the nature and scope of clinicians' obligations to respond in the moment to patients' needs when complete pain relief might not be possible.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 2","pages":"E129-136"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
What Does Our Tolerance of Poor Management of Patients' Pain Have to Do With Reimbursement Inequity for Office-Based Gynecologic Procedures? 我们对患者疼痛管理不善的容忍与门诊妇科手术的报销不公平有什么关系？
AMA journal of ethics Pub Date : 2025-02-01 DOI: 10.1001/amajethics.2025.137
Nishita Pondugula, Parmida Maghsoudlou, Vardit Ravitsky, Louise P King
{"title":"What Does Our Tolerance of Poor Management of Patients' Pain Have to Do With Reimbursement Inequity for Office-Based Gynecologic Procedures?","authors":"Nishita Pondugula, Parmida Maghsoudlou, Vardit Ravitsky, Louise P King","doi":"10.1001/amajethics.2025.137","DOIUrl":"10.1001/amajethics.2025.137","url":null,"abstract":"<p><p>Office-based gynecologic procedures (OBGPs) are reimbursed at lower rates than similar office urology and dermatology procedures. But there is a broader \"hidden curriculum\" in health professions training that perpetuates clinicians' and organizations' acceptance of these patterns of poor reimbursement, disincentivizes research on improving OBGP pain management, and exacerbates tolerance of poor control of patients' OBGP pain. This article suggests strategies for equitable reimbursement that would also likely motivate better, more equitable OBGP pain control.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 2","pages":"E137-148"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How Should Meaningful Evidence Be Generated From Datasets? 如何从数据集生成有意义的证据？
AMA journal of ethics Pub Date : 2025-01-01 DOI: 10.1001/amajethics.2025.27
Caroline E Morton, Christopher T Rentsch
{"title":"How Should Meaningful Evidence Be Generated From Datasets?","authors":"Caroline E Morton, Christopher T Rentsch","doi":"10.1001/amajethics.2025.27","DOIUrl":"https://doi.org/10.1001/amajethics.2025.27","url":null,"abstract":"<p><p>Datasets are often considered \"ideal\" when they are large and contain longitudinal and representative data. But even research that uses ideal datasets might not generate high-quality evidence. This article emphasizes the roles that transparency plays in enhancing observational epidemiological findings' credibility and relevance and argues that epidemiological research can produce high-quality evidence even when datasets are not ideal. This article also summarizes strategies for bolstering transparency in key phases of research planning and application.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 1","pages":"E27-33"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
What Should Health Professions Students Learn About Data Bias? 关于数据偏差，卫生专业的学生应该学些什么？
AMA journal of ethics Pub Date : 2025-01-01 DOI: 10.1001/amajethics.2025.14
Douglas Shenson, Beverley J Sheares, Chelesa Fearce
{"title":"What Should Health Professions Students Learn About Data Bias?","authors":"Douglas Shenson, Beverley J Sheares, Chelesa Fearce","doi":"10.1001/amajethics.2025.14","DOIUrl":"https://doi.org/10.1001/amajethics.2025.14","url":null,"abstract":"<p><p>In epidemiology, bias is defined as systematic deviation from the truth, and it can arise at different stages of scientific investigation (eg, data collection, methodological application, and outcomes analysis). Epidemiological bias can appear as a consequence of data bias (usually categorized as selection bias or information bias) or social bias (prejudice). Such forms of bias may occur separately or together. This article explores what health professions students should learn about the relationship between data bias and social bias-generated by racial, ethnic, gender, or other kinds of prejudice, singly or in combination-as a source of ethical and clinical concern in health care practices and policies that influence patient care and community health.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 1","pages":"E14-20"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How Should Epidemiologists Respond to Data Genocide? 流行病学家应如何应对数据灭绝？
AMA journal of ethics Pub Date : 2025-01-01 DOI: 10.1001/amajethics.2025.44
Abigail Echo-Hawk, Sofia Locklear, Sarah McNally, Lannesse Baker, Sacena Gurule
{"title":"How Should Epidemiologists Respond to Data Genocide?","authors":"Abigail Echo-Hawk, Sofia Locklear, Sarah McNally, Lannesse Baker, Sacena Gurule","doi":"10.1001/amajethics.2025.44","DOIUrl":"10.1001/amajethics.2025.44","url":null,"abstract":"<p><p>Data quality for and about American Indian/Alaska Native (AI/AN) people is undermined by deeply entrenched, colonial practices that have become standard in US federal data systems. This article draws on cases of maternal mortality and COVID-19 to demonstrate the ethical and clinical need for inclusive, diverse, and accurate data when researching AI/AN health trends. This article further argues that epidemiologists specifically must challenge implicit bias, question methods and practices, and recognize colonial, racist reporting practices about AI/AN people that have long undermined data collection, analytical, and dissemination practices that are fundamental to epidemiological research.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 1","pages":"E44-50"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lessons From the Political History of Epidemiology for Divisive Times. 分裂时期流行病学政治史的教训。
AMA journal of ethics Pub Date : 2025-01-01 DOI: 10.1001/amajethics.2025.58
H K Quinn Valier
{"title":"Lessons From the Political History of Epidemiology for Divisive Times.","authors":"H K Quinn Valier","doi":"10.1001/amajethics.2025.58","DOIUrl":"https://doi.org/10.1001/amajethics.2025.58","url":null,"abstract":"<p><p>Historical precursors of the field we now call epidemiology date back to Hippocrates. Modern epidemiological science, however, developed as domestic and international infectious disease transmission accompanied industrialization, some nations' economic growth, and colonial powers' military expansion and dominance. This article canvasses ways in which modern epidemiology influenced public health innovation from the late 18th century through the mid-19th century. Specifically, this article suggests which lessons can be gleaned from political dimensions of epidemiology's history and applied to orientations to medicine and public health today.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 1","pages":"E58-63"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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