AMA journal of ethics最新文献

Advances in epigenetic age estimation are now applied in actuarial science to make risk assessment more precise. But such health insurance underwriting practices pose ethical and legal questions about discrimination, privacy, and equity in biological data use. Legal adaptations, such as Canada's Genetic Non-Discrimination Act (GNDA) of 2017, aim to protect persons against genetic discrimination but do not evolve as quickly as epigenetic technology. This article examines the GNDA's regulatory limitations and highlights the need for more adaptable legislative strategies.

Dementia is one of the most common developments in our increasing human lifespan. Preventing and postponing it have been important projects of health care that rely on the approval and use of interventions, sometimes in the absence of clinical or ethical consensus about what constitutes meaningful clinical improvement, outcomes, or risk factor modification. This commentary on a case considers these variables and proposes how to improve the general health and well-being of older persons.

Since health care organizations implemented widespread adoption of electronic health records (EHRs), clinicians' notes about patients' care have become longer and more cumbersome, a phenomenon colloquially known as "note bloat." Bulky templates and blocks of data take time to sort through, making it difficult for clinicians to discern what is clinically and ethically relevant in prior clinicians' notes about their encounters with a patient. This article considers important consequences of long, dense notes for clinicians, including less time to spend face-to-face with patients. Bloated notes have other consequences for teaching and for clinician well-being, so this article proposes a less-is-more approach to electronic documentation that focuses on making important information about a patient easier to find, illuminating clinical reasoning, and promoting efficiency, concision, and clarity in EHR documentation practices.

Electronic health records are now critical in day-to-day health care operations. A drawback to using them, however, is that they tend to divert clinicians' focus from patients to a screen. This phenomenon has generated a colloquial reference to patient-screen pairings as an "iPatient." This commentary on a case suggests key points of ethical and clinical relevance about this trend in patient-clinician relationships and clinical encounters.

Electronic health records (EHRs) now generally offer patients immediate access to a broad swath of health information and data they are often not fully prepared to interpret or review. This commentary on a case considers risks and benefits of open access to EHRs and strategies for mitigating patient anxiety caused by immediate access, including improving patient understanding of data, tools to promote health literacy, and customizable EHR information access options.

This commentary on a case analyzes how integrating ambient listening and transcription technologies powered by artificial intelligence into the electronic health record documentation process influences documentation practices and clinical encounters. The commentary offers best-practice recommendations for informed consent processes and patient-clinician relationship formation.

This commentary on a case canvasses federal and some organizational rules applicable to health record keeping and considers these in light of "open notes." Accuracy of information in health records, accountability for remediating inaccuracies, and ownership are considered as key areas of ethics investigation.