Ethics

Responding to patients’ bias: Know where to draw the line

The most vulnerable individuals in health care encounters are patients. This is the main reason to respect a patient’s preferences. However, there are limits to what a physician should be expected to tolerate when patients’ preferences express unjust bias.

The June issue of theAMA Journal of Ethics®(@JournalofEthics) features numerous perspectives on limits to patient preferences and gives you an opportunity to earn CME credit.

Articles include:

How Should Organizations Support Trainees in the Face of Patient Bias?Concrete protocols for supporting trainees include convening team meetings, tracking bias incidents, collecting data and initiating protective changes in culture.

How Should Clinicians and Trainees Respond to Each Other and to Patients Whose Views or Behaviors Are Offensive?Affect labeling during painful bias incidents helps caregivers identify their duties to patients while enabling their own healing.

How Should Physicians Respond to Patient Requests for Religious Concordance? Patient-physician concordance is a matter of degree. In certain circumstances, greater concordance can motivate important goals of medicine.

How Should Organizations Respond to Racism Against Health Care Workers? When patients express overt racism, caregivers need to feel safe and supported. The scope of organizations’ responsibilities to make that happen needs to be clearly defined.

Listen and learn

In the journal’s June podcast, expert AMA member Fatima Cody Stanford, MD, MPH, an obesity medicine specialist in Boston and assistant professor at Harvard Medical School, discusses a delicate tension between preserving relationships with patients who express bias and preserving one’s own dignity.

Kimani Paul-Emile, JD, PhD, is a professor at Fordham University School of Law in New York City, associate director and head of domestic programs and initiatives at the Center on Race, Law and Justice, and the faculty co-director at the Louis Stein Center for Law and Ethics. On the podcast, she describes how organizations can support physicians and health care team members who experience bias, discrimination or harassment.

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

Submit manuscripts and artwork

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. The journal also invites original photographs, graphics, cartoons, drawings and paintings that explore the ethical dimensions of health or health care.

The AMA Journal of Ethics Conley Art of Medicine contest and Conley Ethics Essay contest for medical students, residents, and fellows are now open.

A look ahead

Upcoming issues of theAMA Journal of Ethicswill focus on ethics of representing unrepresented patients and access to prescription medications. Sign up to receive email alerts when new issues are published.

The AMA Journal of Ethics exists to help health professionals, students and clinicians navigate ethical decisions in service to patients and society by offering cases and analyses, medical education articles, policy discussions, peer-reviewed articles for journal-based CME, visuals, and more. The journal is open-access (no subscription or publication fees) and offers a blend of peer-reviewed content and articles we solicit experts to write.

The journal’s call for theme issue editors is now open. Medical students, residents and fellows in U.S.-based programs are invited to apply to serve as theme issue editors for monthly issues to be published in 2021–2022.