Assistant professor of psychiatry at the Yale University School of Medicine in New Haven, Connecticut.
Albert J. Solnit Integrated Adult/Child Psychiatry Clinical Fellow at the Yale University School of Medicine in New Haven, Connecticut.
AMA J Ethics. 2022 Aug 1;24(8):E781-787. doi: 10.1001/amajethics.2022.781.
Recognizing their roles in iatrogenesis requires clinicians and professions to take responsibility for attitudes and policies that harm patients and waste resources. A striking, neglected set of examples of iatrogenic harm involves persons with severe mental illness (SMI) who seek inpatient medical care. This article describes how medicine, despite spending billions each year trying to respond to acute physical medical needs of persons with SMI, participates in carceral policies and practices that fail to prioritize continuity of care. This article also details clinicians' and professions' responsibilities to mitigate their roles in iatrogenic harm incursion by practicing antiracist, evidence-based, collaborative care to motivate equity, reduce waste, and improve outcomes, especially in crisis responses to patients experiencing acute exacerbations of SMI in inpatient medical care settings.
认识到他们在医源性疾病中的作用，需要临床医生和专业人员对伤害患者和浪费资源的态度和政策负责。一组引人注目的、被忽视的医源性伤害的例子涉及到寻求住院医疗的严重精神疾病（SMI）患者。本文描述了尽管医学每年花费数十亿美元试图应对 SMI 患者的急性身体医疗需求，但它如何参与到监禁政策和未能优先考虑护理连续性的实践中。本文还详细说明了临床医生和专业人员的责任，通过实践反种族主义、基于证据的、协作的护理，减轻他们在医源性伤害中的作用，以促进公平、减少浪费和改善结果，特别是在对住院医疗环境中经历 SMI 急性加重的患者的危机应对中。
