Helping patients manage serious medical and life issues—such as severe disability, depression and barriers to independent living—is a primary concern for physicians practicing in the field of physical medicine and rehabilitation (PM&R). The June issue of the AMA Journal of Ethics takes a close look at ethical issues in the “quality-of-life specialty.”
The physical medicine and rehabilitation specialty aims to improve movement and reduce psychological, emotional, family and vocational stresses that often accompany temporary or permanent loss of motor function. Patients receiving this care can have congenital or acquired conditions that range from spina bifida to traumatic injury to Parkinson’s disease.
Contributors to this month’s issue of the AMA Journal of Ethics tackle the serious ethical questions physiatrists confront as they offer patients encouragement tempered by realistic expectations, arrange safe discharge and follow-up, manage long-term pain, and fight for access to the best rehab care for everyone who needs it. Articles include:
- “Physician paternalism and severe disability: Strengthening autonomy through therapeutic engagement”: Kristi L. Kirschner, MD, examines how one physician helps patients who are depressed, grieving or angry after a severe injury or illness image possible narratives for the next chapter of their lives.
- “Safety and ethical decisions in discharging patients to suboptimal living situations”: James Hill, MD, and William Filer, MD, look at critical considerations in discharge planning that include caregiver trustworthiness and a competent patient’s decision-making prerogative.
- “The disability movement’s critique of rehabilitation’s medical model: A rebuttal”: John D. Banja, PhD, writes that critiques of the “normalization” goals of the medical model of rehabilitation can be dismissive of efforts to remediate oppressive functional deficits.
Learn more about the physical medicine and rehabilitation specialty
For medical students who are deciding on a specialty to pursue after graduation, AMA Wire® offers the “Shadow Me” Specialty Series, which gives honest advice, observations and resources from physicians in different specialties.
The latest physician profiles in this series are from two physicians who practice physical medicine and rehabilitation:
