What are some ethical issues that PM&R faces?

[carlosc1dbz]

I know there are many knowledgeable doctors here, and I would appreciate your input.

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[lobelsteve]

1. Peds: admitting kids for respite care or non-threatening medical issues (eating aversion)
2. EMG: normal exams, normal imaging. EMG to assess for XYZ with no risk factors.
3. Pain: no ethics no pain so no issues.
4. Inpatient: Admitting medically unstable patients to keep admin happy.

 

[carlosc1dbz]

1. Peds: admitting kids for respite care or non-threatening medical issues (eating aversion)
2. EMG: normal exams, normal imaging. EMG to assess for XYZ with no risk factors.
3. Pain: no ethics no pain so no issues.
4. Inpatient: Admitting medically unstable patients to keep admin happy.

They dont sound too bad. In school, we are always talking about abortion issues, and elective surgeries for teens.

 

[PMR 4 MSK]

Some I've had -

60 yo alcoholic female with end-stage Addison's Dz, fell down stairs and fx'd C2, vent-dependent quad (Asia A). Pt wanted the vent turned off, and when that was not done, wanted to be DNR. I handled the entire meeting with pt, family (some via teleconference) nurse and ethics rep. She died 2 days later due to DNR.

50 yo female being seen for chronic pain, being abused by husband, tells me he broke her arm, she told the ER she "slipped and fell." She refused to leave him, until police made him leave, then she took him back.

45 yo female, bipolar, brought her 13-year, bipolar (supposedly, how do you tell in a teen?) opioid-dependent (not addicted, being treated with opioids) to me for pain management.

Man, I could go on for days....

 

[carlosc1dbz]

Some I've had -

60 yo alcoholic female with end-stage Addison's Dz, fell down stairs and fx'd C2, vent-dependent quad (Asia A). Pt wanted the vent turned off, and when that was not done, wanted to be DNR. I handled the entire meeting with pt, family (some via teleconference) nurse and ethics rep. She died 2 days later due to DNR.

50 yo female being seen for chronic pain, being abused by husband, tells me he broke her arm, she told the ER she "slipped and fell." She refused to leave him, until police made him leave, then she took him back.

45 yo female, bipolar, brought her 13-year, bipolar (supposedly, how do you tell in a teen?) opioid-dependent (not addicted, being treated with opioids) to me for pain management.

Man, I could go on for days....

Yeah, im not a big fan of the woman who loves her abusive husband. I see that way too often.