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

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?

The PA asks, "May I place the IV and be present at Mr. Y's execution? Is it unethical to do this?

Mr. James is a 98-year-old single gentleman living with his 92-year-old brother in a one-bedroom apartment. Should Mr. James be placed in a nursing home against his will, and if so, how?

You test a patient for sexually transmitted infections (STIs) at her request. She tests positive for Chlamydia trachomatis infection. You give her medication for the infection, and you counsel her to refrain from having sex with anyone—especially with anyone with whom she has had sex in the past 60 days, until those persons are treated. You ask her to encourage her recent sex partners to be tested and, if necessary, treated. You also provide patient education about chlamydia. You suggest strongly that the patient return for a routine retest and examination in 6 months, explaining carefully that any of her partners who are not effectively treated for chlamydia may reinfect her.

Severe acute respiratory syndrome (SARS), sarin gas, anthrax, hurricane Katrina, the September 11th World Trade Center attack—all of these affect not only the general population but also those who have chosen to be health care providers.

The physician (who is the PA's supervising physician) shares his concerns with the PA about the patient's homosexuality, which he says is an "unhealthy" lifestyle.

Is it the PA's ethical responsibility to determine the reasons for Mr. S.'s lack of adherence? When can a patient be asked to leave the practice because of nonadherence?

The core issue of this case is the use of opioids in the treatment of chronic nonmalignant pain. Complicating the case is the patient's history of addiction. Of the ethics papers that I review for PA students and the ethics questions I receive from PA colleagues, approximately one third involve pain control and the use of opioids. The questions commonly involve patients with a current or past history of addiction.