Nonclinical factors such as unemployment, lack of transportation or a fear of doctors’ offices can impede patients’ medical treatment. But how far should doctors go to assist in these matters?
This month’s issue of the AMA Journal of Ethics examines the delicate balance between a physician’s personal interest in patients and professional boundary guidelines. Contributors help distinguish boundary crossings—benevolent acts outside the scope of clinical interventions—from boundary violations—breaches of practice that may place patients’ bodily or psychological well-being at risk.
The May issue features:
- “Where the rubber meets the road: The challenge of reporting ethical breaches.” Obstacles to reporting include confusion over boundary lines, fear of hurting a colleague and the potential for colleague retaliation, according to the author of this piece.
- “Necessary boundary crossing in pediatrics.” To help a seriously ill young patient whose normal childhood has been disrupted, pediatricians must be more than sympathetic professionals in white coats—they must know how to motivate each patient and then go the extra mile to do so.
- “Professional codes, public regulations and the rebuilding of judgment following physicians’ boundary violations.” The author of this piece believes remedial intervention following boundary violations must emphasize the importance of physician judgment and self-regulation rather than mere knowledge of the “rules.”
Listen to the journal’s May podcast to hear why Gordon D. Schiff, MD, believes that physicians’ human connection to patients sometimes calls on them to openly cross professional boundaries in efforts to help needy patients. Dr. Schiff is a primary care physician and a safety and quality improvement researcher at Harvard Medical School.
Also, take the monthly ethics poll, which asks: Which examples of physician conduct do you think are within the bounds of appropriate professional behavior?
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