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For various reasons pain, fear, or control patients sometimes consider ending their lives; occasionally, they even ask their doctors for help. But ethicists say, before responding to the question as asked, physicians first should look at what might be going on behind the question.
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Given enough experience and patience, a physician can become adept at dealing with patients who they find noncompliant or overly demanding. But how does a clinician deal with a patient he or she finds utterly intolerable to be around someone who is abusive, insulting, or completely unlikable?
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One of your patients is undergoing chemotherapy for cancer and is struggling with severe nausea. She tells you she wants to add acupuncture to her regimen of care; you have never been convinced that acupuncture provides benefits. What is your duty to the patient?
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The push to make hospital infection rates more transparent is, on its face, an institutional and a patient safety issue. But there also is an ethics component, experts say, and health care has a duty to inform the public on hospital-acquired infections and to put that information in perspective so that it is not misleading.
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Some researchers in the UK have renewed debate over the limits placed on medical research by ethics regulations, saying ethical red tape is "stifling" advances in medicine. But ethicists in the United States say the argument is nothing new and that the review process for clinical trials protects both human subjects and research.
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As part of its commitment to eliminating racial and ethnic disparities in health care, CareFirst BlueCross Blue Shield has launched a diabetes disease management program in collaboration with a Washington, DC, clinic that serves a mostly Latino population.
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A case management program for diabetes has resulted in a steady drop in hemoglobin A1C levels and cholesterol levels among members of ConnectiCare, a regional HMO based in Farmington, CT.
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By engaging members who are at high risk for diabetes and getting them into a health management program before the disease creates problems, Blue Cross of California has reduced medical cost for members in its diabetes disease management program by 10% overall.
