AMA journal of ethics最新文献

This article offers examples of connections between built environments and health outcomes and discusses the current state of regulation of built environments. This article also suggests ethical questions about oversight and how health professions trainees can advocate for healthier built environments.

Design is and always has been interventional and clinically relevant. Modern evidence-based designers' lineage was prominently shaped between 1800 and 1970. This article investigates hospital designs during this period that were correlated with patients' health outcomes and suggests how this history influenced our present-day understanding of evidence-based design.

Internationally, there is a long history of improving dementia care quality by focusing on patients' strengths and supporting environments that normalize their daily routines. The European dementia village is a pioneering health care site: 4 acres of integrated housing and amenities that include large exterior walkways around gardens, restaurants, and shops. A US-based conceptual model is the dementia friendly city center, which integrates health care service delivery into adaptive reuse and urban revitalization. This article discusses how these models envision structures and spaces of caregiving and habitation.

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.