AMA journal of ethics最新文献

Urban development often generates noise and light pollution, reduces green space, produces heat islands, and increases population density that can exacerbate crime, disease transmission, anxiety, and stress. This article argues that individuals and communities have rights to not have their space impinged upon by urban plans, designs, or development. This negative right means governments have ethical obligations to develop infrastructure that mitigates adverse health consequences, preserves natural environments, safeguards ecological well-being, and promotes peace and public health.

In this short animation, the artist and her daughter discuss wearing masks during the COVID-19 pandemic. Her daughter's statements reveal one way a child processed growing up with masks and masking.

Peacefulness is a potentially healing inner state that can be fostered by skilled interpersonal interactions. Skilled interactions in health care are those in which clinicians focus on making patients feel seen and heard and that their needs are important and can be met. But data collected in health care encounters tend to place value on consumerism and commodification, both of which undermine clinicians' capacities to skillfully interact with patients in ways that support patients feeling comfortable, if not peaceful. Motivating peace for patients means shifting patterns of how some data are valued relative to other data; this article suggests data measures that can facilitate a shift toward clinical encounters with more capacity for more peaceful interactions.

Bereavement counseling is often offered as a referral following an adverse event or after identification of lingering grief. This article proposes the value of prospective bereavement counseling when a person can reasonably anticipate loss to support anticipatory grief and facilitate supportive continuous care planning for patients experiencing loss. This article positions bereavement counseling as care aimed at finding peace by offering a framework of dimensions of peace, opportunities to foster peace in clinically important moments, and guiding questions to facilitate this clinical outcome in health care settings.

This anecdote of one regional academic health network's reputational demise suggests what might be learned about tendencies of undervaluing chaplaincy expertise, peace, and quiet in the everyday operations of professional caregiving.

Psychedelics have long been used by individuals seeking peace and a sense of wellness. This article examines widespread adoption of ketamine as a proxy for psychedelics. For ketamine, there is a need to protect vulnerable persons from exploitation that should be balanced against risks of hypermedicalization. This article suggests strategies for striking such a balance, including by carefully differentiating between persons with psychiatric illnesses, such as treatment-resistant depression, who could benefit from psychedelics, and persons using psychedelics for peace and wellness under careful guidance.

This commentary on a case of a transgender patient interested in using psychedelics to feel more at peace and achieve a sense of psychological safety argues that health care practitioners can help their patients minimize potential harms of psychedelics by providing psychoeducation and resources to identify clinical trials or skilled and knowledgeable psychedelic practitioners. This approach can support patients' agency in their mental health care and ability to foster moments of peace in their lives.

Promoting peace with patients requires clinicians to be skilled in helping patients feel safe, respected, and heard. Close listening is a teachable skill set that enables clinicians to focus sensory attention on a patient and to cultivate space for reflection before speaking. While communication skills are taught in health professions education, close listening is rarely formally emphasized as an equally important skill. This article draws on musical arts education methods to suggest strategies for teaching close listening that can be applied to peace promotion in patient care.

Historically, Western medicine has recognized health care environments as vital to patient well-being and enhanced clinical outcomes. Yet most modern Western hospitals are primarily designed and regulated to promote safety and minimize risk rather than to enhance comfort or serve as therapeutic environments in and of themselves. Hospice stands out as one of the few places within the Western health care service delivery system in which the structures and spaces of caregiving are viewed as key to patient-centered practice. This commentary on a case suggests the importance of designing health care environments that center patient experiences of well-being throughout the lifespan, not just at the end of life.