jbriscoe.bsky.social
Hospice and Palliative Care Physician
#MedPsych #MedSky #HAPC #Bioethics
Writing @ Notes from a Family Meeting: https://familymeetingnotes.substack.com
431 posts
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289 following
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Authors Emily Moin and Scott Halpern of the @upenn.edu join JAMA Associate Editor Christopher Seymour to discuss how ICU care and outcomes have changed in the US over the past decade.
🎧 Listen now: edhub.ama-assn.org/jn-learning/...
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Thanks Josh - agreed. I don’t discuss the use of fictional examples in medical ethics much, but it’s absolutely an area where there are benefits in preserving patient anonymity and avoiding legal issues in making judgments about actual cases.
I remember finding this good:
philpapers.org/rec/SPRTNR
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Don’t get me wrong. Making the right diagnosis or choosing the right therapy are critical functions of medical practice. But there’s more to the practice of medicine, and making a diagnosis and choosing a therapy will touch on those things (eg, patients’ experience of illness).
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Contrast that with the discussion of a historical case in which the discussion is usually narrowly aimed toward “the right answer.”
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The push for efficiency will overrule any human concerns, ignore human limitations, and manufacture (rather than serve) human need.
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This series on intention, duty, causation, and authority at the end of life is also relevant: familymeetingnotes.substack.com/p/intending-... #medsky #hapc #bioethics
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Sandro Galea discusses more on that issue here: open.substack.com/pub/sandroga... #medsky
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We’ve got a lot of work to do to win back trust as a profession. Merely stamping our collective foot and demanding people follow the evidence overlooks the chasm that separates how people appraise claims and evidence. #medsky
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This has made the profession vulnerable to either being co-opted for politicized agendas or ignored when politics marches forward with an agenda that imperils health.
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We’ve spent ~50 years telling patients that they can make whatever choices they want about their own health, in many ways turning medicine into a service provider rather than a profession. open.substack.com/pub/familyme...
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If only it were so easy. Many of the people overturning healthcare are, in one way or another, patients in our clinics and hospitals. While clinicians can stand their ground on matters of conscience, that won’t win back lost trust.
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Metrics are the only thing that are legible and easily communicated around massive bureaucracies (like healthcare systems). They also offer the promise, to use C. Thi Nguyen's phrase, of value clarity: that aesthetically appealing sense that we know the right thing to do and how to do it.
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…The modern obsession with reductive measuring is absolutely out of control.
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In that sense, we do not die personalized deaths. Our deaths, and whatever choices we can make around them, exemplify our culture and go on to form a culture. #medsky familymeetingnotes.substack.com/p/is-a-life-...
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Stephen Jenkinson observes that we all die the death of our culture. That is, we die the death our culture gives to us. What culture extols death with as little dying as possible, the getting on with it, the efficiency, the using of death as a medical instrument? #medsky
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Writing is conversation, and instructor feedback is a key piece of the dialogue that guides students in their process. There’s a fundamental misperception that it’s about correcting errors or that an AI robot can have the same impact. These “tools” are misguided.
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The clinical resource OpenEvidence does something similar with citing peer reviewed scholarly evidence. They recently signed a deal with a major medical journal too.
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Although I don’t use it, Readcube Papers has an AI function in which you can ask questions about an individual paper or series of papers in your library. This seems like a good use case.
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"AI tools such as message routing systems and ambient scribes have undeniable potential and offer hope for a future where clinicians are freed from administrative burdens in order to focus on their patients." from @ai.nejm.org ...hope springs eternal... ai.nejm.org/doi/full/10....