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November 8, 2021

Neuro-Advocacy—Professionalism in Action

Author Affiliations
  • 1Pacific Neuroscience Institute, Santa Monica, California
  • 2VoteTripling.org, Washington, DC
JAMA Neurol. Published online November 8, 2021. doi:10.1001/jamaneurol.2021.4049
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    1 Comment for this article
    A Unique Mechanism of Quality Care
    Sandro Tsang, PhD | People's Open Access Education Initiative
    Autonomy enables practitioners to act as effective patient advocates (1). The authors implicitly elaborate a crucial role of autonomy in achieving care excellency. Unlike other professions, “the patient[/client] cannot check to see if the actions of [the] physician[/professional] are as diligent as they could be” (2), because the skilled care is an act of applying complex knowledge (3). The “ethically understood restrictions on the activities of a physician are much more severe” than on other professions (3, p.949). For medical care, professional standards and autonomy are enforced by collegiality rather than the legally endorsed authorities (4). The authors point out that, when a patient's mental capacity is impaired, his/her receiving best possible humanistic care is more dependent on the physician's advocacy. Let us hope that this unique mechanism will not be lost in the climate of modernizing medicine through standardization.

    1. Priester R. A values framework for health system reform. Health Affairs. 1992;11(1):84-107.
    2. Arrow K.J. Agency and the Market. In K.J. Arrow and M.D. Intriligator, eds., Handbook of Mathematical Economics, Vol. III. Amsterdam: Elsevier. 1986:p.1184.
    3. Arrow K.J. Uncertainty and the Welfare Economics of Medical Care. The American Economic Review. 1963 Dec;53(5):941-73.
    4. Starbuck WH. Learning by knowledge‐intensive firms. Journal of management Studies. 1992 Nov;29(6):713-40.