In American Indian and Alaska Native communities, inequities in health status and access to care are pervasive and poorly addressed. It is important to understand the origins of historically entrenched patterns of oppression and relationships between current practices and policies that are governing tribal health sites. This can help inform the nature and scope of the individual and collective obligations of physicians and other health professionals. Equity can also be improved through health professions education and research partnerships with Native communities.

Ethics in Health Care

Explore the AMA Journal of Ethics for articles, podcasts and polls that focus on ethical issues that affect physicans, physicians-in-training and their patients.

The October issue of AMA Journal of Ethics® (@JournalofEthics) features numerous perspectives on the ethical, social, and cultural complexities of what it means to deliver just care to Native patients living on sovereign tribal land and across the U.S. You may also earn CME credit.

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Articles include:

  1. How Should Allopathic Physicians Respond to Native American Patients Hesitant About Allopathic Medicine?” 

    1. Most clinicians receive little training in integrating Native healing into allopathic practice, which undermines patients’ autonomy and cultural values.
  2. What Should Physicians Consider About American Indian/Alaska Native Women’s Reproductive Freedom?

    1. For patients historically stripped of control over their reproductive health, consideration of past violations and transparent discussion are key.
  3. Three Levels of Autonomy and One Long-Term Solution for Native American Health Care.” 

    1. Native Americans suffer poverty and significant health inequity and are chronically underrepresented in the clinician workforce.
  4. Racialization as a Barrier to Achieving Health Equity for Native Americans.” 

    1. “Race” is a product of European-American views of phenotypic and cultural differences and continues to influence Native health decision making.

In the journal’s October podcast, Mary Owen, MD—president-elect of the Association of American Indian Physicians—discusses the importance of representation of Native Americans in health professions.

Dr. Owen is also an assistant professor in the Department of Family Medicine and Biobehavioral Health and director for the Center of American Indian and Minority Health at the University of Minnesota Medical School.

The episode also features Em Loerzel, a social worker and PhD student at the University of Washington, discusses violence against Native women and femme-identifying people, meaning persons who do not always dress or act in a "traditionally feminine" way, but who express femme identity through feminine-associated behaviors, interactions and political views.

Listen to previous episodes of the podcast, “Ethics Talk,” or subscribe in iTunes or other services.

The AMA Journal of Ethics CME module, “Ethics Talk: Representation, Sovereignty, and Caring for Native American Patients,” is designated by the AMA for a maximum of 1 AMA PRA Category 1 Credit™.

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The offering is part of the AMA Ed Hub™, an online learning platform that brings together high-quality CME, maintenance of certification, and educational content—in one place—with relevant learning activities, automated credit tracking and reporting for some states and specialty boards.

Learn more about AMA CME accreditation. 

The journal’s editorial focus is on commentaries and articles that offer practical advice and insights for medical students and physicians. Submit a manuscript for publication.

Are you a student or trainee interested in ethics? Become a theme issue editor! There’s still time to apply this month.

Upcoming issues of the AMA Journal of Ethics will focus on risk management ethics as well as socially situated brain death. Sign up to receive email alerts when new issues are published.

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