PA Quandaries Articles

Why physician assistants should consider joining the hospital ethics committee

Jim Anderson, PA-C, ATC 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

F. J. Gianola, PA, DFAAPA 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

F. J. Gianola, PA, DFAAPA 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?
 

Ethical issues surrounding deep brain stimulation in Parkinson's disease

Sierra M. Farris, MPAS, PA-C; F.J. Gianola, PA, DFAAPA February 19, 2009

The team at the clinic faced a dilemma. Should they remove the DBS because it was contributing to the difficulties with nursing home placement? Or should they refuse to remove the DBS because it eased Mrs. D.'s symptoms, even though this would increase the burden of care on her family?
 

The physician assistant's professional obligations and the values of faith

F.J. Gianola, PA, DFAAPA October 01, 2008

Guadalupe Benitez had been with her same-sex partner for many years. They wanted to start a family, but Ms. Benitez had fertility problems due to polycystic ovarian syndrome. Her primary care physician referred her to an infertility clinic, which had the exclusive contract to provide infertility services for members of her insurance plan.
 

Beneficence versus maleficence: Can this PA participate in an execution?

F. J. Gianola, PA, DFAAPA April 01, 2008

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

When a competent elderly man refuses nursing home placement

F. J. Gianola, PA, DFAAPA February 01, 2008

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?
 

Confidentiality, trust, and sexually transmitted infections

F. J. Gianola, PA, DFAAPA December 01, 2007

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.
 

The duty to treat and the realities of the 21st century

F. J. Gianola, PA, DFAAPA August 01, 2007

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.
 

Is "reparative" therapy in the best interest of the patient?

F. J. Gianola, PA, DFAAPA June 01, 2007

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.