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AMA journal of ethics最新文献

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What Are Organizations' Responsibilities When Surgeons Experience Regret? 当外科医生后悔时，组织的责任是什么？
AMA journal of ethics Pub Date : 2025-03-01 DOI: 10.1001/amajethics.2025.216
Amy E Vertrees, Matthew R Endara
{"title":"What Are Organizations' Responsibilities When Surgeons Experience Regret?","authors":"Amy E Vertrees, Matthew R Endara","doi":"10.1001/amajethics.2025.216","DOIUrl":"10.1001/amajethics.2025.216","url":null,"abstract":"<p><p>This article considers the nature and scope of health care organizations' responsibilities to respond to clinicians' regret experiences and suggests that one ethically important reason to do so is to mitigate burnout and prevent decreased patient access to skilled, experienced, and motivated surgeons. This article canvasses possible sources of regret experiences among surgeons and suggests strategies organizations can implement to help support surgeons experiencing regret and to help sustain surgeons' impulses to practice.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 3","pages":"E216-221"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606553","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 Senior Surgeons Help Junior Colleagues and Trainees Experiencing Regret? 资深外科医生应该如何帮助经历后悔的初级同事和实习生？
AMA journal of ethics Pub Date : 2025-03-01 DOI: 10.1001/amajethics.2025.171
Carlie Arbaugh, Kimberly E Kopecky
{"title":"How Should Senior Surgeons Help Junior Colleagues and Trainees Experiencing Regret?","authors":"Carlie Arbaugh, Kimberly E Kopecky","doi":"10.1001/amajethics.2025.171","DOIUrl":"10.1001/amajethics.2025.171","url":null,"abstract":"<p><p>Unanticipated outcomes and adverse events are inevitable in surgical training and practice and tend to elicit complex emotional experiences, including regret. Navigating these experiences with support from mentors and peers is essential for surgeon well-being, a healthy surgical culture, and optimal patient care. Critical incident stress debriefing and metacognitive behavioral models offer tools senior surgeons can use to help junior surgical colleagues in the wake of unanticipated outcomes and adverse events.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 3","pages":"E171-177"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606373","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
Using Policy and Law to Help Reduce Endometriosis Diagnostic Delay. 利用政策和法律帮助减少子宫内膜异位症诊断延误。
AMA journal of ethics Pub Date : 2025-02-01 DOI: 10.1001/amajethics.2025.104
Annika J Penzer, Scott J Schweikart
{"title":"Using Policy and Law to Help Reduce Endometriosis Diagnostic Delay.","authors":"Annika J Penzer, Scott J Schweikart","doi":"10.1001/amajethics.2025.104","DOIUrl":"10.1001/amajethics.2025.104","url":null,"abstract":"<p><p>Despite high incidence of endometriosis internationally and domestically, many patients wait a decade after symptom onset for an accurate diagnosis. This article suggests why diagnostic criteria should be clarified and why endometriosis screening should be incentivized among members of the public, clinicians, and health care organizations.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 2","pages":"E104-109"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123620","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
Performing Clarity, Sincerity, and Endurance. 表现清晰、真诚和忍耐。
AMA journal of ethics Pub Date : 2025-02-01 DOI: 10.1001/amajethics.2025.159
Teddie Bernard
{"title":"Performing Clarity, Sincerity, and Endurance.","authors":"Teddie Bernard","doi":"10.1001/amajethics.2025.159","DOIUrl":"10.1001/amajethics.2025.159","url":null,"abstract":"<p><p>Health beliefs about one's own future should be clearly expressed, sincere, and enduring to be taken seriously by clinicians when assessing risks and benefits in key health decisions. This cartoon considers how clinicians' expressions of doubt about those beliefs can undermine patient-clinician relationships and a patient's epistemic authority.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 2","pages":"E159-160"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123609","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
Treating Patients in Non-Labor and Delivery OB/GYN Examinations and Procedures. 治疗非分娩和分娩患者的妇产科检查和程序。
AMA journal of ethics Pub Date : 2025-02-01 DOI: 10.1001/amajethics.2025.110
Amber R Comer, Meredith Rappaport
{"title":"Treating Patients in Non-Labor and Delivery OB/GYN Examinations and Procedures.","authors":"Amber R Comer, Meredith Rappaport","doi":"10.1001/amajethics.2025.110","DOIUrl":"10.1001/amajethics.2025.110","url":null,"abstract":"<p><p>Non-labor and delivery obstetrics and gynecology (OB/GYN) procedures are an important and necessary part of reproductive health care. However, performing a pelvic exam or procedure, which requires entry through the pelvis, is often an uncomfortable, painful, embarrassing, and anxiety-provoking experience. Given the delicate nature of these examinations and procedures, it is imperative that physicians uphold the inherent trust placed in them that derives from the patient-physician relationship. Respecting a patient's privacy-including physical, informational, decisional, and associational privacy-is a prerequisite for ensuring that a fundamental foundation of trust exists between the patient and physician. This essay explores the ethical issues physicians face during clinical practice when performing non-labor and delivery OB/GYN examinations and procedures.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 2","pages":"E110-116"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123615","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
Learning to Communicate With Patients About Potentially Painful Gynecologic Procedures. 学会与患者沟通潜在的痛苦妇科手术。
AMA journal of ethics Pub Date : 2025-02-01 DOI: 10.1001/amajethics.2025.91
Paula J Adams Hillard
{"title":"Learning to Communicate With Patients About Potentially Painful Gynecologic Procedures.","authors":"Paula J Adams Hillard","doi":"10.1001/amajethics.2025.91","DOIUrl":"10.1001/amajethics.2025.91","url":null,"abstract":"<p><p>Doing painful procedures is a part of obstetrics and gynecology practice. Patients' pain experiences are subjective, diverse, and based on life experiences that can include trauma, adverse childhood events, and previous labor. Learners should have opportunities to gain knowledge about pain and the informed consent process during preclinical medical education, to observe and practice informed consent exchanges that include a discussion of pain and pain management with standardized and real patients during different stages of their training, to receive timely feedback from seasoned clinicians who understand that shared decision-making is an essential component of an informed consent discussion, and to learn from every patient encounter in order to inform the next one (reflective practice).</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 2","pages":"E91-97"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123125","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
Key Roles of Epistemic Humility in OB/GYN Care of Patients in Acute Non-Labor and Delivery Pain Care. 认知谦卑在妇产科患者急性非产程和分娩疼痛护理中的关键作用。
AMA journal of ethics Pub Date : 2025-02-01 DOI: 10.1001/amajethics.2025.117
Kelly K Gillespie
{"title":"Key Roles of Epistemic Humility in OB/GYN Care of Patients in Acute Non-Labor and Delivery Pain Care.","authors":"Kelly K Gillespie","doi":"10.1001/amajethics.2025.117","DOIUrl":"10.1001/amajethics.2025.117","url":null,"abstract":"<p><p>This article considers ethical, epistemic, and clinical harms of normalizing, discounting, or dismissing patients' experiences of acute pain in non-labor and delivery obstetrics and gynecology (OB/GYN) settings. Discrediting patients' accounts undermines the therapeutic capacity of patient-clinician relationships, causes unjustified suffering, and may even contribute to life-threatening delays in recognizing and treating complications. This article urges OB/GYN practitioners to consider the ways in which structural and individual factors predispose them to discredit patients' testimonies and thereby contribute to epistemic and other harms. OB/GYN practitioners are encouraged to cultivate the virtue of epistemic humility and consider the role of patient satisfaction scores in evaluating care.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 2","pages":"E117-128"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123024","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
Response to "Humanity and Inhumanity of Nonhuman Primate Research". 对“非人灵长类动物研究的人性与非人性”的回应。
AMA journal of ethics Pub Date : 2025-02-01 DOI: 10.1001/amajethics.2025.164
Emily R Trunnell, Donya Mand
{"title":"Response to \"Humanity and Inhumanity of Nonhuman Primate Research\".","authors":"Emily R Trunnell, Donya Mand","doi":"10.1001/amajethics.2025.164","DOIUrl":"https://doi.org/10.1001/amajethics.2025.164","url":null,"abstract":"","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 2","pages":"E164-166"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123614","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 Physicians Manage Abortion Pain Experienced by Remote Telehealth Patients? 医生应该如何处理远程医疗患者流产时的疼痛？
AMA journal of ethics Pub Date : 2025-02-01 DOI: 10.1001/amajethics.2025.79
Eloise Smellie, John J Reynolds-Wright
{"title":"How Should Physicians Manage Abortion Pain Experienced by Remote Telehealth Patients?","authors":"Eloise Smellie, John J Reynolds-Wright","doi":"10.1001/amajethics.2025.79","DOIUrl":"10.1001/amajethics.2025.79","url":null,"abstract":"<p><p>Pain is a recognized adverse effect of medication abortion, but its management has been understudied. This commentary on a case draws on principles of nonmaleficence, beneficence, and autonomy to consider equity in remote and in-person medication abortion pain management.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 2","pages":"E79-85"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123854","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 a Physician Respond to a Patient's Unexpected Pain During a Pelvic Examination When There Is Clinical Indication of Infection? 当有感染的临床指征时，医生应该如何应对骨盆检查中患者意外的疼痛？
AMA journal of ethics Pub Date : 2025-02-01 DOI: 10.1001/amajethics.2025.86
Kelsy Schultz, Charita L Roque
{"title":"How Should a Physician Respond to a Patient's Unexpected Pain During a Pelvic Examination When There Is Clinical Indication of Infection?","authors":"Kelsy Schultz, Charita L Roque","doi":"10.1001/amajethics.2025.86","DOIUrl":"10.1001/amajethics.2025.86","url":null,"abstract":"<p><p>This commentary on a case considers how to navigate a pelvic exam in the context of a patient's personal experience and suggests the clinical and ethical importance of thoughtful, intentional action and consistent, clear communication in these clinical encounters.</p>","PeriodicalId":38034,"journal":{"name":"AMA journal of ethics","volume":"27 2","pages":"E86-90"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123850","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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