RT Book, Section
A1 Saunders, Milda R.
A1 Alexander, G. Caleb
A1 Siegler, Mark
A2 McKean, Sylvia C.
A2 Ross, John J.
A2 Dressler, Daniel D.
A2 Brotman, Daniel J.
A2 Ginsberg, Jeffrey S.
SR Print(0)
ID 56193192
T1 Chapter 32. Principles of Medical Ethics
T2 Principles and Practice of Hospital Medicine
YR 2012
FD 2012
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-160389-8
LK accessmedicine.mhmedical.com/content.aspx?aid=56193192
RD 2024/04/19
AB Hospitalists,  like  all  physicians,  must  master  not  only  the  clinical,  but  also  the  interpersonal  and  ethical  dimensions  of  medical  practice.  Four  features  of  Hospital  Medicine  generate  particular  ethical  challenges  for  the  practicing  clinician.  First,  hospitalized  patients  often  face  urgent  medical  issues  in  the  midst  of  uncertainty.  Second,  the  patient  and  the  hospitalist  are  usually  strangers  to  one  another,  having  met  for  the  first  time  when  the  patient  is  admitted  to  the  hospitalists'  service.  Decisions  about  code  status,  end-of-life  care,  or  aggressiveness  of  care,  difficult  under  the  best  circumstances,  become  even  more  difficult  because  hospitalists  do  not  have  the  continuity  of  care  many  outpatient  physicians  have  with  their  patients.  Third,  despite  laudable  efforts  by  many  hospitalists  to  communicate  with  primary  care  providers,  the  absence  of  long-standing  relationships  with  patients  increases  the  challenge  of  knowing  and  representing  their  wishes  and  best  interests  during  the  course  of  clinical  care.  Finally,  hospitalists'  shift  work  also  poses  challenges  to  the  communication  and  trust  required  for  sound  clinical  decision  making.  Patients  and  family  members  may  begin  a  conversation  about  the  goals  and  plan  of  care  with  one  hospitalist  only  to  have  to  continue  such  a  conversation  with  another  covering  physician.