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A Piece of My Mind
December 12, 2001

The Consultation

JAMA. 2001;286(22):2781-2782. doi:10.1001/jama.286.22.2781

Each week we gather as physicians (including a psychiatrist), fellows, lawyers, philosophers, students, and nurses in a conference room to discuss cases and concepts and hope we are practicing medical ethics. We try to be guided by principles and ideas codified in books and taught in medical schools: principles such as autonomy and beneficence, ideas such as substituted judgment, even concrete documents such as advance directives. It is a language that many in medicine have grown increasingly accustomed to hearing, and it's one that is supposed to help us analyze dilemmas. But what about when the principles leave the case unresolved? Or worse, what about when the principles leave the case resolved and the feelings raw?

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