Physicians' Power to Name

Definitions of disease rely not only on pathophysiology, but also on social and cultural norms. How physicians use their authority to label patients' conditions affects how symptoms are understood and addressed, whether and to what extent treatments are reimbursed, and patterns of empathy expression towards affected individuals. Contrasts between concepts such as disease and health, illness and wellness, normal and deviant, natural and unnatural, each suggest that medicine's exercise of the power to name is often imperfect and always ethically relevant. 

Volume 20, Number 12: E1113-1216 Full Issue PDF
  • From the Editor
    Dec 2018

    What Are Ethical Ramifications of a Physician’s Power to Name?

    Alexandra Charrow, MD, MBE
    Whether conditions are recognized as pathological can influence how symptoms get addressed and how treatments get reimbursed. When we choose to call something a disease, even our expressions of empathy towards individual patients can change.
    AMA J Ethics. 2018;20(12):E1115-1118. doi: 10.1001/amajethics.2018.1115.
  • Case and Commentary
    Dec 2018

    When Should Iatrogenic Polypharmacy Be Considered a Disease?

    Christine Wieseler, PhD
    When symptoms of polypharmacy are consistent with those of difficult-to-diagnose disorders, reliable determinations about which drugs are necessary is critical.
    AMA J Ethics. 2018;20(12):E1133-1138. doi: 10.1001/amajethics.2018.1133.
  • Policy Forum
    Dec 2018

    Who Should Regulate Preimplantation Genetic Diagnosis in the United States?

    Michelle Bayefsky
    Professional society guidelines can be used to set standards for clinical practice instead of government. This approach could help if federal or state policymakers view discarding embryos as ethically equivalent to abortion.
    AMA J Ethics. 2018;20(12):E1160-1167. doi: 10.1001/amajethics.2018.1160.
  • Medicine and Society
    Dec 2018

    Beyond the Nature/Medicine Divide in Maternity Care

    Jessica Martucci, PhD, MBE
    Childbirth in hospitals settings is considered by some to be medicalized and not natural. When medicalization is associated with loss of autonomy and control, clinicians should be aware of how they express respect for women during in-hospital births.
    AMA J Ethics. 2018;20(12):E1168-1174. doi: 10.1001/amajethics.2018.1168.
  • Medicine and Society
    Dec 2018

    Why We Should Stop Using the Term “Elective Abortion”

    Katie Watson, JD
    Distinguishing between elective and therapeutic abortions undermines the moral agency of patients and disproportionately amplifies moral rather than medical dimensions of the procedure.
    AMA J Ethics. 2018;20(12):E1175-1180. doi: 10.1001/amajethics.2018.1175.
  • Medicine and Society
    Dec 2018

    Three Things Clinicians Should Know About Disability

    Joel Michael Reynolds, PhD
    Clinicians can practice disability humility by developing social understandings of disability. This can help clinicians improve communication and express respect for patients’ authority about their experiences.
    AMA J Ethics. 2018;20(12):E1181-1187. doi: 10.1001/amajethics.2018.1181
  • Medicine and Society
    Dec 2018

    Historical Situatedness of Categories’ Meanings in Medicine

    Sander L. Gilman, PhD
    Dichotomies, such as reconstructive vs aesthetic surgery and medical vs cosmetic dermatology, can distort meanings of surgical procedures. This can compromise the value of procedures themselves and practices for their reimbursement.
    AMA J Ethics. 2018;20(12):E1188-1194. doi: 10.1001/amajethics.2018.1188.
  • History of Medicine
    Dec 2018

    Why Naming Disease Differs From Naming Illness

    Marvin J. H. Lee, PhD, MDiv
    Clinicians tend to view obesity as a disease, while members of the body positivity movement value their bodies as they are. Should clinicians treat obesity as a disease in patients who don’t see themselves as ill?
    AMA J Ethics. 2018;20(12):E1195-1200. doi: 10.1001/amajethics.2018.1195.
  • History of Medicine
    Dec 2018

    Naming and the Public Health Roles of Physicians

    Kelsey Walsh, MA
    The American Medical Association named alcoholism and addiction as illnesses during the 20th century. Obesity, smoking, and motor vehicle safety were also named as public health issues and targeted in poster advertising campaigns.
    AMA J Ethics. 2018;20(12):E1201-1211. doi: 10.1001/amajethics.2018.1201.
  • Personal Narrative
    Dec 2018

    Trafficked

    Stephen P. Wood, MS, ACNP
    Identifying patients who are trafficked is key to caring well for these vulnerable adults and children. But labeling patients as trafficked can stigmatize patients if clinicians aren’t trained well in trauma-informed care.
    AMA J Ethics. 2018;20(12):E1212-1216. doi: 10.1001/amajethics.2018.1212.
  • podcast1-1812
    Podcast
    Dec 2018

    Ethics Talk: Why Does It Matter When We Call Abortion “Elective”

    Labels commonly used in clinical settings, like “elective” or “therapeutic,” influence how we think about the justifiability of abortion. We talk with Professor Katie Watson and Dr Maryl Sackeim about how the language clinicians use to describe abortion can affect patients’ experiences and even cause harm.