AFP DEPARTMENT COLLECTION
This department addresses legal, psychological, and ethical issues physicians may encounter in their day-to-day practice. Each article contains a brief case scenario, followed by a commentary section written by a consultant who responds to the particular issue addressed in the scenario.
Jul 1, 2019 Issue
Helping Patients Cope with Grief
The loss of a loved one, especially a spouse or a child, is perhaps one of the most difficult events a person will experience in a lifetime. The resulting grief can be overwhelming and incapacitating for a time. Family physicians can be sources of comfort to those who grieve the loss of someone close to them.
Jun 1, 2019 Issue
An Unhappily Married Patient
Overall, marriage enhances health. Men gain greater health benefits from marriage than their wives. Conversely, wives are more negatively affected by a bad marriage than their husbands. In general, the health benefit of marriage is maximized in a good marriage but negated in a bad marriage.
Jan 1, 2019 Issue
Effective Advocacy for Patients and Communities
Family physicians play diverse roles in society, often bridging individual and community perspectives. Family physicians' ethics require providing care to all persons regardless of their geographic, economic, political, racial, religious, or sexual orientation status.
Dec 1, 2018 Issue
Practical Considerations of Caring for Patients Abroad During Short-term Medical Trips
A 65-year-old woman presented on the second day of my week-long volunteer medical brigade to a migrant camp in Mexico. The patient had a blood pressure of 180/110 mm Hg and a heart rate of 78 beats per minute. Her presenting symptoms were itchy eyes and sneezing, which she reported were worse when she worked outside harvesting produce. She was otherwise asymptomatic.
Sep 15, 2018 Issue
Violence in the Health Care Setting: What Can We Do?
n July 2017, Dr. Todd Graham was fatally shot by his patient's husband when Dr. Graham denied his patient's request for opioids. This case highlights that, according to the Bureau of Labor Statistics, health care professions are one of the most dangerous industries of employment in the United States.
Jul 1, 2018 Issue
The Doorknob Phenomenon in Clinical Practice
By definition, the doorknob phenomenon or doorknob statement occurs when patients wait until the last moment in the clinical encounter—often while the physician is grasping the doorknob to exit the examination room—to utter something that, not uncommonly, provides crucial information. Physicians must then determine whether to pursue this new information immediately or to defer the new issue until the next visit.
May 1, 2018 Issue
Clinical and Personal Utility of Genetic Risk Testing
On April 6, 2017, the U.S. Food and Drug Administration (FDA) approved marketing of the 23andMe Personal Genome Service, the first direct-to-consumer genetic test. This test uses genomic DNA collected from mail-in saliva collection kits to provide information on a patient's genetic risk of certain medical diseases or conditions.
Mar 1, 2018 Issue
Medical Aid in Dying
Requests for hastened death are not unusual from patients with life-limiting illness, and many primary care physicians encounter these requests over the course of their career. Medical aid in dying is the practice of a physician providing a competent, terminally ill patient—at the patient's request—with a prescription for a lethal dose of medication that the patient intends to use to end his or her own life.
Jan 1, 2018 Issue
Female Genital Mutilation or Cutting
FGM/C involves partial or total removal of the external genitalia or other injury to the female genital organs for nonmedical reasons. It is considered a human rights violation. It has no known health benefits, but many reported harmful consequences.