Ethics

Should PAs assess and address the impact of implicit bias on patient care?

April 24, 2012

Implicit bias is so subtle that colleagues may not recognize it in themselves. Among the signs to watch for are loss of patient autonomy and lack of fairness in treatment.
 

The ethics of coding: 
Are we committing fraud?

, Matthew Hill, MDiv October 19, 2011

What are the ethical obligations of health care providers? Since auditors look to the medical record to validate billing, providers are expected to document thoroughly and completely on every case.
 

In remembrance of Ground Hero: Ten years after 9-11

September 21, 2011

Less than a month after the Attack on America, I was fortunate to see unselfishness transcend the nation and manifest even around the globe. Like so many Americans after 9-11, I too had a desire to "do something" and was given that opportunity.
 

Physician assistants for sale: 
Will prescribe for food

August 19, 2011

The evidence is consistent: Clinicians believe that their colleagues' prescribing behaviors are impacted by interactions with drug representatives but that their own practices are not. Unfortunately, they are wrong.
 

Is it better to give, receive, or decline? The ethics of receiving gifts from patients

June 28, 2011

The issue of gift giving by patients requires more study, and medical communities would benefit from a sustained effort to examine the complex issues involved in accepting gifts from patients.
 

Social Media Body Snatchers II: Into the Ethics

May 10, 2011

A few things are true: a pencil never made anyone have a mean or offensive thought; email cannot force well-intentioned providers to think bad thoughts about their bosses; and Facebook/Twitter are not capable of sending secret electronic waves into someone's head.
 

Eliminating health disparities: What works?—February 2011

February 23, 2011

A recent issue of the AMA's "Virtual Mentor" contains an excellent commentary on the different ways that the US and the UK approach obesity. While the UK makes systematic changes in how it approaches obesity, we continue to view it here as an individual, psychological problem of the obese individual.
 

A tale of two kidneys

January 05, 2011

Years ago, a particularly talented science fiction writer by the name of Larry Niven wrote a disturbing story about a dystopia in which those convicted of crimes were forced to donate organs as a punishment. The Governor of Mississippi, Haley Barbour, has recently taken a step toward making this a reality.
 

Is it ethical to substitute restraints for 
adequate treatment resources?

, Reamer Bushardt, PharmD, PA-C December 08, 2010

Given that the potential for abuse is considerable, the authors suggest that a policy of minimally restraining patients, increased training, and optimizing restraint alternatives is vital to prevent unethical practice.
 

Washington State Board of Pharmacy says, "It's about me"

November 15, 2010

The Washington State Board of Pharmacy has it all backwards and continues to push on into the Big Muddy, even as they pass the waist-deep mark. Bioethical principles are not about providers, they are about patients.
 

Are free drug samples in the best interest of our patients?

November 05, 2010

The author argues that PAs should consider the pros and cons of distributing free drug samples and decide whether to do so based on the PA profession's ethical principles of beneficence, nonmaleficence, and justice.
 

Inside the AAPA Policy Manual—October 2010

October 25, 2010

The author focuses on the Guidelines for Ethical Conduct for the Physician Assistant Profession, explaining why he finds this position paper so inspiring.
 

Is it ethical to provide enteral tube feedings for patients with dementia?

, October 01, 2010

Research does not offer any clear support for or against this practice, making this a difficult decision for both the patient's family and the clinician.
 

Ducks in the road, zebras in the house

August 30, 2010

Last spring, my son cried as I drove him to school. His tears stemmed from loss rather than from flutters of classroom anxiety. My son had missed out on seeing something special. In this instance, the special was a small male duck that had emerged from the undergrowth and wandered into the middle of the road, causing me to stop the car.
 

Is banning direct-to-consumer advertising (DTCA) consistent with bioethical principles?

August 11, 2010

The impact of DTCA on patients' expectations and PAs' responsibility to provide bioethical treatment are reviewed.
 

Eliminating health disparities: What works?—June 2010

June 23, 2010

This column describes recent literature on health disparities, emphasizing tools that can help clinicians to assess and address disparities in their own practices.
 

Does the right to bear children guarantee access to treatment for infertility?

June 21, 2010

The law protects the right of all patients to procreate, but clinicians should consider the welfare of the child born as a result.
 

Is it ethically permissible to mandate influenza vaccination for health care workers?

June 09, 2010

Patient autonomy does not always transcend to health care workers. The author makes a case for patient safety to be an overruling factor.
 

Health care volunteerism: What PAs need to know before making a trip

From PPC, the Professional Practice Council of the AAPA May 06, 2010

The Professional Practice Council provides an overview of what to consider before joining a short-term global health care mission.
 

Eyes wide shut: Can casual use of medical evidence cause harm and erode bioethical values?

, , April 23, 2010

A complex patient case illustrates a range of societal and clinical biases and the impact these biases can have on patient care.
 

Why physician assistants should consider joining the hospital ethics committee

February 18, 2010

Service on an ethics committee allows PAs to learn how to apply bioethical principles, and it allows their colleagues to learn more about PAs.
 

The ethics of using placebos for diagnosis and treatment in clinical practice

December 21, 2009

The case of a man with lifelong allergies suggests that a placebo, used honestly and openly, may be a useful therapeutic tool.
 

Terminating your professional relationship with a patient

April 02, 2009

In a previous installment of this column, we discussed the duty to treat in times of health and safety disasters. Does the same duty to treat exist when personal threat, abuse, and possible injury are being committed by a member of your patient's family?
 

Why the attitude?

Eizabeth McPhilomy, PA-C March 16, 2009

Isn't it more ethical to give our patients a plan with the tools that can help them succeed than merely to state the obvious need for weight loss and exercise at their annual appointment?
 

You just can't trust the histories

September 01, 2006

It isn't like the Free World. Getting the truth out of patients is like going round and round with the questions, peeling a rotten onion.
 

It’s 8 AM. Do you know who your gay and lesbian patients are?

October 01, 2005

While applying for PA school, I shadowed a PA at a busy pediatric clinic. During a wellness visit, the PA asked a 16-year-old male if he had a girlfriend. The young man shifted his gaze downward and bashfully answered "no." The PA had assumed that this patient was heterosexual when to me he appeared to be gay. This assumption, however benign it may seem on the exterior, probably sent a subtle yet powerful message to this young man: It's not okay to be gay; you aren't like the rest of us.
 

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