Does a Patient's Trauma History Ethically Justify a Discriminatory Clinical Referral?

AMA J Ethics

A professor at Creighton University in Omaha, Nebraska, with appointments in the Center for Health Policy and Ethics, the Department of Interdisciplinary Studies, and the Department of Medicine in the School of Medicine; and the co-founder and co-director of the Center for Promoting Health and Health Equality, a community-academic partnership.

Published: June 2019

This article analyzes a child psychiatrist's referral approach when the patient's care must be transferred to an adult psychiatrist and the otherwise best adult psychiatrist has "accented" language, which is associated with the patient's prior trauma. The analysis considers the value of simplicity and a related "simplicity strategy," revealing that many ethical factors lay behind the simplicity approach. The inquiry then addresses simplicity regarding practical wisdom and context. The paper argues that simplicity should mean considering just what's relevant and no more. Applied to the case, simplicity includes respect for persons, openness, honesty, trustworthiness, beneficence, nonmaleficence, ethics of care, professional empathy, group inquiry, epistemic humility, and justice. An objection regarding undue complexity is noted and refuted.

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http://dx.doi.org/10.1001/amajethics.2019.493DOI Listing

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