A Moratorium on the Euphemism MAID.

It is essential for high-quality health care for providers to adhere to the principle of truth telling, speaking with clarity and honesty. The euphemism medical aid in dying, MAID, is being mainstreamed in the medical literature by proponents of physician-assisted suicide and euthanasia. This trend is deleterious because MAID's proponents do not consistently express the meaning and intent of the practice, and the phrase downplays the fact that a provider is participating in the act of death for a patient. The euphemism blurs the differences between providing high-quality palliative care and participating in the death of a patient prior to a natural death. Some believe the term MAID is used exclusively for assisted suicide in patients with a terminal diagnosis with less than 6 months to live, when in fact it is being used for both assisted suicide and euthanasia and for patients who have no terminal diagnosis with potentially years to live. We are calling up on our colleagues to cease the use of this and other euphemisms in this ethically controversial practice. We recommend standardized language that accurately denotes the context and process. Provider Assisted Death by Prescription (PAD-P) and Provider Assisted Death by Administration (PAD-A) are terms that most accurately describe the process, taking into account who is prescribing or administering a lethal substance and the outcome of the actions. Literature that addresses this practice should be described as ending life literature. The standardized language needs to be used on death certificates so we can most accurately assess the impact that provider-assisted death is having on society. Emphasizing truth telling in morally controversial practices will foster trust among health care providers and with patients.

The Secret of Quality Is Love: A Qualitative Study Exploring Physician and Nurse Perspectives on What It Means to Love Their Patients.

Little research systematically explores healthcare professionals' understanding of what it means to love their patients. The authors hypothesized that nurses and physicians would describe a language of love relevant to health care. Researchers conducted structured interviews with 29 physicians and 32 nurses at an academic medical center through a combination of purposive, convenience, and snowball sampling. Interviews were transcribed verbatim and analyzed using grounded theory, identifying major themes from qualitative data. Most nurses and physicians declared they should love their patients. Characteristics of loving physicians and nurses included caring, clinical excellence, advocating, meeting needs, compassion, sacrifice, and tough love. Moral imperatives included the duty to act on behalf of the patient's best interest, respect the patient's wishes, treat patients as you would want your family treated, and recognize limits of life. Many physicians and nurses commented that loving patients could transform health care. Physicians and nurses described characteristics and imperatives of love that may serve as an ethical standard for healthcare professionals.

Medical student reflections: Chaplain shadowing as a model for compassionate care training.

PURPOSE: Training of compassionate and empathetic physicians requires commitment by educators to make it a priority. Chaplains typically have time and training to effectively demonstrate compassionate care in the clinical setting. This qualitative study aims to explore perceived benefits among medical students from pastoral care shadowing in integrating compassion and spirituality into education curricula. METHODS: Sixty-four written reflections from first- and second-year medical students were collected from December 2018 to January 2020 after shadowing with hospital chaplains. Unprompted reflections were analyzed using coding networks. RESULTS: Four major themes identified included (1) learned values within pastoral care, (2) learned roles of pastoral care in the healthcare setting, (3) practiced spiritual assessment tools and resource identification, and (4) reflected personal impact on future career. Within each major theme, three to four sub-themes were further identified. CONCLUSIONS: Reflections support chaplain shadowing as a model for emphasizing spiritual and compassionate care through role-modeling, hands-on learning and reflective practices.

An interprofessional cohort analysis of student interest in medical ethics education: a survey-based quantitative study.

BACKGROUND: There is continued need for enhanced medical ethics education across the United States. In an effort to guide medical ethics education reform, we report the first interprofessional survey of a cohort of graduate medical, nursing and allied health professional students that examined perceived student need for more formalized medical ethics education and assessed preferences for teaching methods in a graduate level medical ethics curriculum. METHODS: In January 2018, following the successful implementation of a peer-led, grassroots medical ethics curriculum, student leaders under faculty guidance conducted a cross-sectional survey with 562 of 1357 responses received (41% overall response rate) among students enrolled in the School of Medicine, College of Nursing, Doctor of Physical Therapy and BS/(D) MD Professional Scholars programs at The Medical College of Georgia at Augusta University. An in person or web-based questionnaire was designed to measure perceived need for a more in-depth medical ethics curriculum. RESULTS: The majority of respondents were female (333, 59.3%), white (326, 58.0%) and mid-20s in age (340, 60.5%). Almost half of respondents (47%) reported no prior medical ethics exposure or training in their previous educational experience, while 60% of students across all degree programs reported an interest in more medical ethics education and 92% noted that an understanding of medical ethics was important to their future career. Over a quarter of students (28%) were interested in pursuing graduate-level training in medical ethics, with case-based discussions, small group peer settings and ethics guest lectures being the most desired teaching methods. CONCLUSIONS: The future physician, nursing and physical therapist workforce in our medical community demonstrated an unmet need and strong interest for more formal medical ethics education within their current coursework. Grassroots student-driven curricular development and leadership in medical ethics can positively impact medical education. Subsequent integration of interprofessional training in medical ethics may serve as a vital curricular approach to improving the training of ethically competent healthcare professionals and overcoming the current hierarchical clinical silos.

Common questions in managing hyperlipidemia.

Hyperlipidemia is a serious disease that affects the health and well-being of many, and further complicates other chronic illnesses. When treating a patient who has a lipid disorder, it is wise to take a global approach to the problem by assessing the patient's history and risk factors, collaborating on developing a healthy lifestyle plan to which the patient can commit, and initiating appropriate therapy when indicated.