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AMA journal of ethics最新文献

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COVID-19 in 2024. 2024年的COVID-19。
AMA journal of ethics Pub Date : 2025-03-01 DOI: 10.1001/amajethics.2025.227
Teddie Bernard
{"title":"COVID-19 in 2024.","authors":"Teddie Bernard","doi":"10.1001/amajethics.2025.227","DOIUrl":"10.1001/amajethics.2025.227","url":null,"abstract":"<p><p>This manuscript focuses on regret as a significant moral experience in surgical professionalization. It distinguishes between constructive regret, which encourages self-reflection and growth, and destructive regret, which can lead to emotional withdrawal and impaired decision-making. This article also offers recommendations for how both colleagues and organizations should respond to each type of regret, especially regret over poor outcomes, to nourish professional formation. Recognizing the tipping point at which regret shifts from a positive driver of improvement to a source of harm is essential.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 3","pages":"E227-228"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606117","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
Experiencing and Coping With Regret After a Patient's Poor Outcome. 经历和应对病人糟糕结果后的后悔。
AMA journal of ethics Pub Date : 2025-03-01 DOI: 10.1001/amajethics.2025.191
Amber R Comer, Meredith Rappaport
{"title":"Experiencing and Coping With Regret After a Patient's Poor Outcome.","authors":"Amber R Comer, Meredith Rappaport","doi":"10.1001/amajethics.2025.191","DOIUrl":"10.1001/amajethics.2025.191","url":null,"abstract":"<p><p>Most clinicians dedicate their professional lives to ensuring their patients' well-being. Despite clinicians' best efforts, however, patients can experience poor outcomes, some of which might be iatrogenic, but many of which are beyond the scope of clinicians' control during any specific clinical encounter or course of care. Such poor outcomes might lead some clinicians to feel regret. This article considers how the AMA Code of Medical Ethics can support physicians while they cope with regret due to a patient's poor health outcome.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 3","pages":"E191-196"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606219","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
Teletherapy Ethics. 远距治疗道德。
AMA journal of ethics Pub Date : 2025-03-01 DOI: 10.1001/amajethics.2025.235
Teddie Bernard
{"title":"Teletherapy Ethics.","authors":"Teddie Bernard","doi":"10.1001/amajethics.2025.235","DOIUrl":"10.1001/amajethics.2025.235","url":null,"abstract":"<p><p>This manuscript focuses on regret as a significant moral experience in surgical professionalization. It distinguishes between constructive regret, which encourages self-reflection and growth, and destructive regret, which can lead to emotional withdrawal and impaired decision-making. This article also offers recommendations for how both colleagues and organizations should respond to each type of regret, especially regret over poor outcomes, to nourish professional formation. Recognizing the tipping point at which regret shifts from a positive driver of improvement to a source of harm is essential.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 3","pages":"E235-236"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606550","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
Stage, Cut, Investigate, Regret, Heal. 舞台，切割，调查，后悔，治愈。
AMA journal of ethics Pub Date : 2025-03-01 DOI: 10.1001/amajethics.2025.229
Maximilian Schaefer
{"title":"Stage, Cut, Investigate, Regret, Heal.","authors":"Maximilian Schaefer","doi":"10.1001/amajethics.2025.229","DOIUrl":"10.1001/amajethics.2025.229","url":null,"abstract":"<p><p>This manuscript focuses on regret as a significant moral experience in surgical professionalization. It distinguishes between constructive regret, which encourages self-reflection and growth, and destructive regret, which can lead to emotional withdrawal and impaired decision-making. This article also offers recommendations for how both colleagues and organizations should respond to each type of regret, especially regret over poor outcomes, to nourish professional formation. Recognizing the tipping point at which regret shifts from a positive driver of improvement to a source of harm is essential.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 3","pages":"E229-234"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606519","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
Which Systemic Responses Should We Evolve to Help Surgeons Navigate Their Regret Experiences? 我们应该发展哪些系统反应来帮助外科医生处理他们的后悔经历？
AMA journal of ethics Pub Date : 2025-03-01 DOI: 10.1001/amajethics.2025.178
Ryan X Lam, Ruhi Thapar, Eric J Silberfein, Lorenzo R Deveza
{"title":"Which Systemic Responses Should We Evolve to Help Surgeons Navigate Their Regret Experiences?","authors":"Ryan X Lam, Ruhi Thapar, Eric J Silberfein, Lorenzo R Deveza","doi":"10.1001/amajethics.2025.178","DOIUrl":"10.1001/amajethics.2025.178","url":null,"abstract":"<p><p>Regret in surgical practice is typically construed as resulting from the commission or the omission of a specific action at a specific decision point, which leads to a deleterious outcome. This article suggests a need to expand this conception of surgical regret to better account for surgeons' regret experiences arising from factors beyond their control. The commentary accompanying the case investigates these external sources of regret, such as resource limitations or professional interpersonal dynamics that prevent a desired outcome from being realized. It also discusses the normative value of addressing surgeons' experiences of regret, especially as a catalyst to facilitate positive systemic changes to ameliorate surgeons' kindred experiences of moral distress, burnout, and compassion fatigue.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 3","pages":"E178-184"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606556","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 Professional Resistance Be Integrated Into Conceptions of Professional Accountability? 职业阻力应如何融入职业问责的概念？
AMA journal of ethics Pub Date : 2025-03-01 DOI: 10.1001/amajethics.2025.185
Rachel Ellaway, Lisa Graves, Tasha R Wyatt
{"title":"How Should Professional Resistance Be Integrated Into Conceptions of Professional Accountability?","authors":"Rachel Ellaway, Lisa Graves, Tasha R Wyatt","doi":"10.1001/amajethics.2025.185","DOIUrl":"10.1001/amajethics.2025.185","url":null,"abstract":"<p><p>As more health professions students, trainees, and clinicians engage in acts of professional resistance, professional accountability is needed when acts of resistance influence patient care. This article suggests standards that can help distinguish between professional and nonprofessional resistance and prioritize minimizing harm and injustice to patients.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 3","pages":"E185-190"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606367","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
Should Xenotransplantation Surgeries Be Authorized Under the Food and Drug Administration's Expanded Access Pathway? 异种移植手术应该在美国食品和药物管理局的扩大准入途径下被批准吗？
AMA journal of ethics Pub Date : 2025-03-01 DOI: 10.1001/amajethics.2025.197
Christopher Bobier, Daniel J Hurst, Daniel Rodger
{"title":"Should Xenotransplantation Surgeries Be Authorized Under the Food and Drug Administration's Expanded Access Pathway?","authors":"Christopher Bobier, Daniel J Hurst, Daniel Rodger","doi":"10.1001/amajethics.2025.197","DOIUrl":"10.1001/amajethics.2025.197","url":null,"abstract":"<p><p>This article examines use of the US Food and Drug Administration's (FDA's) expanded access pathway to permit cardiac xenotransplants. This article first argues that, although data are collected from cardiac xenotransplant surgeries authorized through the FDA's expanded access pathway, uses of preclinical trial data do not align with the FDA's stated aims of expanded access. This article also argues that potential risks of xenotransplantation merit greater caution than risks posed by devices and that it is unclear how caution about such risks is regarded and operationalized during the FDA's expanded access authorization processes.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 3","pages":"E197-200"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606426","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 Understand Regret as a Moral Psychological Experience That Can Influence Clinical Decision-Making? 我们应该如何理解后悔作为一种道德心理经验，可以影响临床决策？
AMA journal of ethics Pub Date : 2025-03-01 DOI: 10.1001/amajethics.2025.222
Sarah L Spaulding, Katherine Fischkoff
{"title":"How Should We Understand Regret as a Moral Psychological Experience That Can Influence Clinical Decision-Making?","authors":"Sarah L Spaulding, Katherine Fischkoff","doi":"10.1001/amajethics.2025.222","DOIUrl":"10.1001/amajethics.2025.222","url":null,"abstract":"<p><p>This manuscript focuses on regret as a significant moral experience in surgical professionalization. It distinguishes between constructive regret, which encourages self-reflection and growth, and destructive regret, which can lead to emotional withdrawal and impaired decision-making. This article also offers recommendations for how both colleagues and organizations should respond to each type of regret, especially regret over poor outcomes, to nourish professional formation. Recognizing the tipping point at which regret shifts from a positive driver of improvement to a source of harm is essential.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 3","pages":"E222-226"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606378","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 Might the Use of Shared Decision-Making With a Patient Mitigate Surgeon Regret in Circumstances of a Poor Outcome Not Due to Error? 在不是由于错误导致的不良结果的情况下，与患者共同决策的使用如何减轻外科医生的遗憾？
AMA journal of ethics Pub Date : 2025-03-01 DOI: 10.1001/amajethics.2025.201
Josh Sommovilla
{"title":"How Might the Use of Shared Decision-Making With a Patient Mitigate Surgeon Regret in Circumstances of a Poor Outcome Not Due to Error?","authors":"Josh Sommovilla","doi":"10.1001/amajethics.2025.201","DOIUrl":"10.1001/amajethics.2025.201","url":null,"abstract":"<p><p>Surgeons might experience regret after interventions for high-risk patients who have poor outcomes, even when no errors occurred. Some regret experiences stem from incomplete communications or miscommunications about options, expectations, or prognoses. Experiences of regret, and even moral distress, might be mitigated when surgeons share key surgical care decisions with patients or their surrogates and draw on strategies for communicating well about patients' serious illnesses or injuries. Shared decision-making is a communication framework whose principles may contribute to mitigation of surgeon regret.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 3","pages":"E201-206"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606228","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
Regret Is Endemic to Surgical Professional Life and Navigating It Is a Skill. 后悔是外科职业生涯的通病，克服后悔是一种技能。
AMA journal of ethics Pub Date : 2025-03-01 DOI: 10.1001/amajethics.2025.169
Kimberly E Kopecky
{"title":"Regret Is Endemic to Surgical Professional Life and Navigating It Is a Skill.","authors":"Kimberly E Kopecky","doi":"10.1001/amajethics.2025.169","DOIUrl":"https://doi.org/10.1001/amajethics.2025.169","url":null,"abstract":"","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 3","pages":"E169-170"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606399","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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