The Journal of clinical ethics
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A commentary on a case of a man who is left a "high quad" (ventilator dependant as well as quadriplegic) after an accident discusses the following: The right of patients who sustain catastrophic injuries to choose to discontinue life-sustaining treatment, The role of capacity assessment in treatment decisions and in ethics consultations, The role of advance directives (ADs) for such patients if they lack capacity, Whether a do-not-resuscitate or do-not-attempt-resuscitation order should be seen as "a medical order" or an advance directive, Some hints about what might be intended when a patient refers to the criterion of having a "meaningful life."
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The AMA Council on Ethical and Judicial Affairs (CEJA) has initiated an important discussion on medical professionalism and the use of social media by issuing thoughtful and practical guidance for physicians and medical students. The implications of online activities for trust in the profession, as well as for trust between patient and doctor, however, will need further exploration as digital life expands and evolves.
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The recent report of the AMA Council on Ethical and Judicial Affairs (CEJA), "Professionalism in the Use of Social Media," describes the types of social media medical professionals use, outlines ways in which existing AMA policies address issues of online professionalism, and makes a list of recommendations for physicians to maintain online professionalism. CEJA recommends directed efforts towards educating physicians about the benefits and pitfalls of social media and, in particular, underscores the difficulties of maintaining professional boundaries in the digital age. In this commentary, we highlight issues introduced by the report and suggest some specific ways that the recommendations of the committee can be implemented by medical schools, residency programs, and practicing physicians.
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This issue's "Legal Briefing" column covers recent legal developments involving institutional healthcare ethics committees. This topic has been the subject of recent articles in JCE. Healthcare ethics committees have also recently been the subject of significant public policy attention. ⋯ Confidentiality. 7. Immunity. 8. Litigation and court cases.
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The rising use of social media, for both clinical and nonclinical purposes, obviates the need for policy to more explicitly guide physicians, and their behaviors, in this new digital environment. The current report from the AMA Council on Ethical and Judicial Affairs (CEJA) addresses a number of these issues, specifically the nature of interaction and representation between physicians and patients. However, given the nature of the focus of this report-the nonclinical use of the internet and social media-there are a number of issues that deserve attention, in particular encouraging education and addressing how to approach relationships among medical professionals of varying levels of training.