This commentary on a case considers how clinicians should help patients interpret results of tests that might be personally meaningful but not clinically actionable. Tests of biological age, for example, can easily lead to patient misunderstandings that can increase risks of psychological harm and make age-related discrimination seem justifiable. This commentary suggests that companies offering epigenetic testing should be more transparent about these tests' reliability and limitations.
Advances in public health, medicine, and technology since the mid-19th century have redefined what is considered "natural" for human beings. This article situates contemporary geroscience in that historical context. The development of gerotherapies must be guided by historical insight, ethical foresight, and a commitment to justice. Since extending lifespans has important societal consequences, how aging research will affect future generations should be prioritized. Equitable access to gerotherapies, as well as an emphasis on social responsibility and the influence of community on health and longevity, must remain central to any vision of the future of aging.
Advances in epigenetic age estimation are now applied in actuarial science to make risk assessment more precise. But such health insurance underwriting practices pose ethical and legal questions about discrimination, privacy, and equity in biological data use. Legal adaptations, such as Canada's Genetic Non-Discrimination Act (GNDA) of 2017, aim to protect persons against genetic discrimination but do not evolve as quickly as epigenetic technology. This article examines the GNDA's regulatory limitations and highlights the need for more adaptable legislative strategies.
Documenting one's assessment of a patient's physical appearance during a clinical encounter is regarded as a key element in a clinician's overall judgment of a patient's health. This article considers ethically and clinically relevant uses and misuses of such appraisals in clinical practice when applied to judgments of a patient's agedness. Despite being a possible invitation for negative clinician bias, such appraisals should be part of clinical encounters and training.
Advances in public health, medicine, and technology since the mid-19th century have redefined what is considered "natural" for human beings. This article situates contemporary geroscience in that historical context. The development of gerotherapies must be guided by historical insight, ethical foresight, and a commitment to justice. Since extending lifespans has important societal consequences, how aging research will affect future generations should be prioritized. Equitable access to gerotherapies, as well as an emphasis on social responsibility and the influence of community on health and longevity, must remain central to any vision of the future of aging.
Pursuit of longevity has become both a biomedical frontier and a booming consumer enterprise. Popular "anti-aging" products-ranging from dietary supplements to skin care and hormone therapies-are commonly promoted as slowing or even reversing aging. At the same time, scientific advances in geroscience are yielding candidate gerotherapeutics and biomarkers for aging that will increasingly generate questions about their applicability, utility, safety, and ethical integration into care. While geroscience holds promise for extending health span, its impact will depend on how this knowledge is integrated into practice and aligned with individual values and priorities, health equity, and prevention of age-related conditions across the lifespan. This article explores the implications of geroscience, particularly for the care of older adults, by examining clinicians' role in ethical incorporation of gerotherapeutics in practice and concludes by making systems-level recommendations.
Dementia is one of the most common developments in our increasing human lifespan. Preventing and postponing it have been important projects of health care that rely on the approval and use of interventions, sometimes in the absence of clinical or ethical consensus about what constitutes meaningful clinical improvement, outcomes, or risk factor modification. This commentary on a case considers these variables and proposes how to improve the general health and well-being of older persons.
This article argues that inequitable access to interventions capable of dramatically extending human lifespans would undermine individual and collective upkeep of civic virtue. Specifically, intervention maldistribution that normalizes the expectation of differential lifespans based on socioeconomic status undermines the moral agency of persons living with poverty and the commonality of lifespan experiences, such as milestones and events. As a result of their greater access to interventions that significantly increase lifespan, those with wealth might be tempted to regard persons living with poverty as biologically distinct, physiologically inferior, and less deserving of moral consideration than themselves.
This commentary on a case analyzes how integrating ambient listening and transcription technologies powered by artificial intelligence into the electronic health record documentation process influences documentation practices and clinical encounters. The commentary offers best-practice recommendations for informed consent processes and patient-clinician relationship formation.
Since health care organizations implemented widespread adoption of electronic health records (EHRs), clinicians' notes about patients' care have become longer and more cumbersome, a phenomenon colloquially known as "note bloat." Bulky templates and blocks of data take time to sort through, making it difficult for clinicians to discern what is clinically and ethically relevant in prior clinicians' notes about their encounters with a patient. This article considers important consequences of long, dense notes for clinicians, including less time to spend face-to-face with patients. Bloated notes have other consequences for teaching and for clinician well-being, so this article proposes a less-is-more approach to electronic documentation that focuses on making important information about a patient easier to find, illuminating clinical reasoning, and promoting efficiency, concision, and clarity in EHR documentation practices.
Electronic health records are now critical in day-to-day health care operations. A drawback to using them, however, is that they tend to divert clinicians' focus from patients to a screen. This phenomenon has generated a colloquial reference to patient-screen pairings as an "iPatient." This commentary on a case suggests key points of ethical and clinical relevance about this trend in patient-clinician relationships and clinical encounters.
Electronic health records (EHRs) enable patients to access their health records anytime, from anywhere with internet connectivity. Yet not all Americans benefit from these innovations. EHRs can be hard to access for people with a range of disabilities. This lack of access perpetuates inequity and, thus, demands ethical and legal attention. Some federal laws and regulations require accessible EHRs, but even these protections can fall short. This article argues that more clearly defined obligations for EHR developers and clinicians are necessary.
Electronic health records (EHRs) enable patients to access their health records anytime, from anywhere with internet connectivity. Yet not all Americans benefit from these innovations. EHRs can be hard to access for people with a range of disabilities. This lack of access perpetuates inequity and, thus, demands ethical and legal attention. Some federal laws and regulations require accessible EHRs, but even these protections can fall short. This article argues that more clearly defined obligations for EHR developers and clinicians are necessary.
