A Doctor’s First, and Last, Responsibility is to Care Comment on “Denial of Treatment to Obese Patients—the Wrong Policy on Personal Responsibility for Health”

The obesity epidemic raises important and complex issues for clinicians and policy-makers, such as what clinical and public health measures will be most effective and most ethically-sound. While Nir Eyal’s analysis of these issues is very helpful and while he correctly concludes that “conditioning the very aid that patients need in order to become healthier on success in becoming healthier” is wrong, further discussions of these issues must include unequivocal support for safeguarding the fundamental moral basis of the doctor-patient relationship. Regardless of any patients’ failures to demonstrate effective responsibility for their own health, each patient needs and deserves a physician whose caring is never in doubt. Policy- makers need to ensure that our health systems always make this a top priority

Clinical review: Influenza pandemic – physicians and their obligations

An influenza pandemic threatens to be the most lethal public health crisis to confront the world. Physicians will have critical roles in diagnosis, containment and treatment of influenza, and their commitment to treat despite increased personal risks is essential for a successful public health response. The obligations of the medical profession stem from the unique skills of its practitioners, who are able to provide more effective aid than the general public in a medical emergency. The free choice of profession and the societal contract from which doctors derive substantial benefits affirm this commitment. In hospitals, the duty will fall upon specialties that are most qualified to deal with an influenza pandemic, such as critical care, pulmonology, anesthesiology and emergency medicine. It is unrealistic to expect that this obligation to treat should be burdened with unlimited risks. Instead, risks should be minimized and justified against the effectiveness of interventions. Institutional and public cooperation in logistics, remuneration and psychological/legal support may help remove the barriers to the ability to treat. By stepping forward in duty during such a pandemic, physicians will be able to reaffirm the ethical center of the profession and lead the rest of the healthcare team in overcoming the medical crisis

A Doctor’s First, and Last, Responsibility is to Care Comment on “Denial of Treatment to Obese Patients—the Wrong Policy on Personal Responsibility for Health”

The obesity epidemic raises important and complex issues for clinicians and policy-makers, such as what clinical and public health measures will be most effective and most ethically-sound. While Nir Eyal’s analysis of these issues is very helpful and while he correctly concludes that “conditioning the very aid that patients need in order to become healthier on success in becoming healthier” is wrong, further discussions of these issues must include unequivocal support for safeguarding the fundamental moral basis of the doctor-patient relationship. Regardless of any patients’ failures to demonstrate effective responsibility for their own health, each patient needs and deserves a physician whose caring is never in doubt. Policy- makers need to ensure that our health systems always make this a top priority

Interdisciplinary education:evaluation of palliative care training for pre-professionals.

Purpose. Medical education inadequately prepares students for interdisciplinary collaboration, an essential component of palliative care and numerous other areas of clinical practice. This study developed and evaluated an innovative interdisciplinary educational program in palliative care designed to promote interdisciplinary exchange and understanding. Method. The study used a quasi-experimental longitudinal design. Thirty-three medical students (third and fourth year) and 38 social work students (second year of masters degree) were recruited. The intervention group students (21 medical and 24 social work students) participated in a series of four training sessions over four weeks while the control group students received written materials after the study. The curriculum and teaching methods were based on theories of professional socialization and experiential learning. The intervention included experiential methods to promote interdisciplinary interaction to foster communication, exchange of perspectives, and the building of mutual trust and respect. Both groups completed assessments of perceived role understanding, a primary component of effective interdisciplinary teamwork, in palliative care. Self-administered surveys were completed at baseline, intervention completion, and three months later. The intervention group also completed an anonymous evaluation about the interdisciplinary education. Results. The intervention group demonstrated a significant increase in perceived role understanding compared with the control group. Three-month follow-up data suggested that intervention group subjects maintained gains in perceived role understanding. Conclusion. An interdisciplinary educational intervention improves role understanding early in the process of professional socialization in a pilot program. Further implementation of interdisciplinary education should evaluate the effect on subsequent interdisciplinary practice and the quality of patient care. (C) 2004 Association of American Medical College