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AMA journal of ethics最新文献

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How Might Health Care Think About the Ethics of Human Extinction? 医疗保健如何看待人类灭绝的伦理？
AMA journal of ethics Pub Date : 2025-08-01 DOI: 10.1001/amajethics.2025.549
Devin M Kellis, Émile P Torres
{"title":"How Might Health Care Think About the Ethics of Human Extinction?","authors":"Devin M Kellis, Émile P Torres","doi":"10.1001/amajethics.2025.549","DOIUrl":"10.1001/amajethics.2025.549","url":null,"abstract":"<p><p>Is there an important ethical difference between a global catastrophe that causes human extinction and one that does not? This commentary on a case introduces 3 approaches-equivalence, further-loss, and pro-extinctionist-in responding to this question. In particular, focus is placed on equivalence and further-loss views' implications for how clinicians, health professions, and health care organizations orient themselves ethically towards managing the risk of extinction.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 8","pages":"E549-558"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761639","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
Why Should Extinction Medicine Be a Specialty? 为什么灭绝医学应该成为一门专业？
AMA journal of ethics Pub Date : 2025-08-01 DOI: 10.1001/amajethics.2025.571
Devin M Kellis
{"title":"Why Should Extinction Medicine Be a Specialty?","authors":"Devin M Kellis","doi":"10.1001/amajethics.2025.571","DOIUrl":"https://doi.org/10.1001/amajethics.2025.571","url":null,"abstract":"<p><p>This commentary on a case builds on recent literature on climate change, health, and human extinction to argue in favor of a new clinical specialty: extinction medicine. If based on precise application of scientific findings about species extinction, disaster prevention and management, and health policy, such a specialty could help reduce humanity's extinction risk. Finally, the commentary suggests extinction medicine competencies, who might become an extinction medicine clinician, and how the specialty might be launched.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 8","pages":"E571-581"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761676","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
Medicine, Futures, and the Prevention of Human Extinction. 医学、未来和防止人类灭绝。
AMA journal of ethics Pub Date : 2025-08-01 DOI: 10.1001/amajethics.2025.588
Bruce E Tonn, Christopher R Tonn
{"title":"Medicine, Futures, and the Prevention of Human Extinction.","authors":"Bruce E Tonn, Christopher R Tonn","doi":"10.1001/amajethics.2025.588","DOIUrl":"https://doi.org/10.1001/amajethics.2025.588","url":null,"abstract":"<p><p>This article draws a parallel between ethical reasons why people alive today have obligations to members of future generations and ethical reasons why physicians have obligations, besides helping improve patients' quality of life, to help some patients confront their own deaths and human extinction. This article argues for the view that many clinicians tend to express-daily, and one patient at a time-ethical values that support human extinction prevention as a project of medicine.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 8","pages":"E588-592"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761641","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
EMS Service Integration in American Indian and Native Alaskan Rural Communities. 美国印第安人和阿拉斯加土著农村社区的EMS服务整合。
AMA journal of ethics Pub Date : 2025-07-01 DOI: 10.1001/amajethics.2025.525
Chelsea Tsasse, John Shufeldt
{"title":"EMS Service Integration in American Indian and Native Alaskan Rural Communities.","authors":"Chelsea Tsasse, John Shufeldt","doi":"10.1001/amajethics.2025.525","DOIUrl":"10.1001/amajethics.2025.525","url":null,"abstract":"<p><p>This article outlines several initiatives to optimize and expand emergency medical services (EMS) in American Indian and Native Alaskan (AI/NA) rural communities. It highlights the significance of cultural humility, cost-effectiveness, equity, and tribal sovereignty in EMS licensure and describes key infrastructure improvements (eg, roads and communication systems) to EMS responsiveness in AI/NA rural communities. This article also examines practical and financial strategies for integrating telehealth and drone-based delivery of critical medicines into rural EMS response capacity.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 7","pages":"E525-529"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545294","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 Might the Past Suggest About Rural Emergency Services Amidst Critical Access Hospitals' Decline? 在关键医院数量下降的情况下，过去对农村急诊服务的建议是什么？
AMA journal of ethics Pub Date : 2025-07-01 DOI: 10.1001/amajethics.2025.530
Siân Lewis-Bevan, Stephen Powell
{"title":"What Might the Past Suggest About Rural Emergency Services Amidst Critical Access Hospitals' Decline?","authors":"Siân Lewis-Bevan, Stephen Powell","doi":"10.1001/amajethics.2025.530","DOIUrl":"https://doi.org/10.1001/amajethics.2025.530","url":null,"abstract":"<p><p>Critical access and other rural hospitals have struggled to remain open, which exacerbates inequity in rural residents' access to routine and emergency health services and strains already-taxed rural emergency medical services (EMS). This article discusses the recent history of rural hospital closures and their effects on rural emergency care. This article also suggests modifications to EMS policy and practice that could improve rural community members' access to health services and bolster EMS services in rural areas.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 7","pages":"E530-536"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545299","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
When Is It Justifiable for an Inexperienced but Licensed Clinician to Perform a High-Risk but Low-Frequency Procedure on a Patient in a Prehospital Setting? 一个没有经验但有执照的临床医生在院前对病人进行高风险但低频率的手术在什么情况下是合理的？
AMA journal of ethics Pub Date : 2025-07-01 DOI: 10.1001/amajethics.2025.497
Elizabeth Reiche, Shaila Coffey, Emma Zeratsky
{"title":"When Is It Justifiable for an Inexperienced but Licensed Clinician to Perform a High-Risk but Low-Frequency Procedure on a Patient in a Prehospital Setting?","authors":"Elizabeth Reiche, Shaila Coffey, Emma Zeratsky","doi":"10.1001/amajethics.2025.497","DOIUrl":"10.1001/amajethics.2025.497","url":null,"abstract":"<p><p>In prehospital settings, clinicians make difficult decisions that need to be made in short periods of time and be within their scope of practice, procedural skill set, and appropriate to their training and preparation. This commentary on a case offers a just culture approach to learning, especially after sentinel events.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 7","pages":"E497-502"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545301","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 We Fund and Reimagine EMS to Support Sustainable Rural Health Infrastructure? 我们应该如何资助和重新构想EMS以支持可持续的农村卫生基础设施？
AMA journal of ethics Pub Date : 2025-07-01 DOI: 10.1001/amajethics.2025.503
Michael Levy
{"title":"How Should We Fund and Reimagine EMS to Support Sustainable Rural Health Infrastructure?","authors":"Michael Levy","doi":"10.1001/amajethics.2025.503","DOIUrl":"https://doi.org/10.1001/amajethics.2025.503","url":null,"abstract":"<p><p>Emergency medical services (EMS) care in rural areas of the United States has suffered from being chronically under-resourced and understaffed for many years. Deficits, to a large extent, are due to how EMS is funded and due to shortfalls in staffing and equipment. Licensed volunteers often staff EMS units in rural areas, but recruitment and retention of skilled professional and volunteer caregivers is stifled by waning numbers. If further expansion of our nation's ambulance deserts is to be avoided, policy action must be taken to adequately fund, as well as to reimagine, rural EMS care.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 7","pages":"E503-509"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545296","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
I Pressed Down. 我按了下去。
AMA journal of ethics Pub Date : 2025-07-01 DOI: 10.1001/amajethics.2025.537
David M Sine
{"title":"I Pressed Down.","authors":"David M Sine","doi":"10.1001/amajethics.2025.537","DOIUrl":"https://doi.org/10.1001/amajethics.2025.537","url":null,"abstract":"<p><p>In emergency medical services prehospital care, situational awareness means that not everything is in a textbook and that not all care is about the patient in front of you.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 7","pages":"E537-540"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545297","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
According to Which Criteria Should a Return EMS Trip of Long Duration and Distance Be Deemed Ethically Justifiable? 根据什么标准，长时间和长距离的回程EMS应被认为是合乎道德的？
AMA journal of ethics Pub Date : 2025-07-01 DOI: 10.1001/amajethics.2025.491
Casey Patrick
{"title":"According to Which Criteria Should a Return EMS Trip of Long Duration and Distance Be Deemed Ethically Justifiable?","authors":"Casey Patrick","doi":"10.1001/amajethics.2025.491","DOIUrl":"https://doi.org/10.1001/amajethics.2025.491","url":null,"abstract":"<p><p>Assessing and adequately documenting a patient's decision-making capacity is a responsibility and skill required of all emergency medical services (EMS) personnel. However, emergency medical technicians' and paramedics' training in a patient's refusal of EMS transport is often limited to evaluating that patient's alertness and orientation. This commentary argues that this approach is too narrow and outlines the obligation of prehospital care personnel to examine the patient thoroughly, obtain a complete set of vital signs, explain prospective risks and benefits of EMS transport, determine capacity, and express support for the patient. Finally, the commentary outlines what it means to appropriately document a prehospital interaction with a patient and express respect for decisions of patients with capacity.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 7","pages":"E491-496"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545293","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 Rural EMS Funding Streams Be Improved? 如何改善农村医疗服务资金流？
AMA journal of ethics Pub Date : 2025-07-01 DOI: 10.1001/amajethics.2025.518
James Small
{"title":"How Should Rural EMS Funding Streams Be Improved?","authors":"James Small","doi":"10.1001/amajethics.2025.518","DOIUrl":"https://doi.org/10.1001/amajethics.2025.518","url":null,"abstract":"<p><p>This article considers how to reliably provide emergency medical services (EMS). EMS responses are critical functions of local governments, yet, in rural areas, many are staffed by licensed volunteers. As requests for emergency health services increase and the workforce decreases, transitioning to a paid workforce is critical to maintaining response capacity. This article discusses the need and mechanisms for more robustly funding rural EMS systems.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 7","pages":"E518-524"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545295","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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