AMA journal of ethics最新文献

Safety-net hospitals care for patients who are incarcerated and are key environments in which surgical trainees learn to wield their professional autonomy. This article explores ethical questions raised by surgical trainees' participation in carceral care and canvasses possible responses to those questions.

The focus of the American Medical Association (AMA) on health care for persons who are incarcerated was in response to the US Supreme Court's 1964 Cooper v Pate holding. This article summarizes key points from AMA work during the 1970s that led to further development of carceral care standards by the National Commission on Correctional Health Care.

Stoma care is very challenging, and, with the added hardship of incarceration, patients find it very difficult to navigate living with a stoma and having it reversed in a timely fashion. Incarceration history adds to the clinical and ethical complexity of surgical care for patients who require an ostomy, especially when secondary to trauma. This commentary on a case canvasses strategies for responding to long-term needs of formerly incarcerated patients with an ostomy who need good follow-up care as much as they need support reintegrating into communities.

This commentary on a case considers surgeons' legal and ethical obligations to patients who are incarcerated and accompanied by carceral facility personnel.

Regret is ubiquitous in surgical practice and emphasizes the nature and breadth of surgeons' responsibilities to patients and colleagues. Expressing regret to patients requires transparent and honest communication but can leave surgeons vulnerable. This article recommends strategies for communicating regret to patients and suggests how organizations and colleagues can help surgeons trying to cope with regret experiences continue their professional growth.

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.

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.

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.

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.

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.