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CME / ABIM MOC

When the Family Caregiver Is a Physician: Negotiating the Ethical Boundaries

  • Authors: Case History and Commentary by Sheryl Mitnick, MPH, RN, and Lois Snyder Sulmasy, JD
  • CME / ABIM MOC Released: 2/21/2020; Reviewed and Renewed: 2/6/2023
  • Valid for credit through: 2/6/2024, 11:59 PM EST
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  • Credits Available

    Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s)™

    ABIM Diplomates - maximum of 0.25 ABIM MOC points

    You Are Eligible For

    • Letter of Completion
    • ABIM MOC points

Target Audience and Goal Statement

This article is intended for physician/family caregivers and physicians treating patients who have physician/family caregivers.

The goal of this activity is to describe ethical issues involved in treating, assisting, and advocating for patients who have physician/family caregivers, according to an American College of Physicians (ACP) ethics case study.

Upon completion of this activity, participants will be able to:

  • Describe ethically appropriate responsibilities of physicians involved in caregiving for ill family members or loved ones, according to an ACP ethics case study
  • Determine ethically appropriate responsibilities of physicians treating patients who have physician/family caregivers, according to an ACP ethics case study
  • Describe other ethical considerations involved in treating, assisting, and advocating for patients who have physician/family caregivers, according to an ACP ethics case study


Disclosures

As an organization accredited by the ACCME, Medscape, LLC, requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest.

Medscape, LLC, encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.


Authors, Case History and Commentary

  • Sheryl Mitnick, MPH, RN

    Multi-Institutional Project Manager
    Clinical Research Unit
    Abramson Cancer Center
    University of Pennsylvania
    Philadelphia, Pennsylvania

    Disclosures

    Disclosure: Sheryl Mitnick, MPH, RN, has disclosed no relevant financial relationships.

  • Lois Snyder Sulmasy, JD

    Director
    Center for Ethics and Professionalism
    American College of Physicians
    Philadelphia, Pennsylvania

    Disclosures

    Disclosure: Lois Snyder Sulmasy, JD, has disclosed no relevant financial relationships.

Authors of Updates

  • Daniel T. Kim, MPH, MA, PhD Candidate

    University of Chicago
    Chicago, Illinois
    (Former) Senior Associate
    Center for Ethics and Professionalism
    American College of Physicians
    Philadelphia, Pennsylvania

    Disclosures

    Disclosure: Daniel Kim, MPH, MA, PhD Candidate has disclosed no relevant financial relationships.

  • Paula S. Katz

    Associate
    Center for Ethics and Professionalism
    American College of Physicians
    Philadelphia, Pennsylvania

    Disclosures

    Disclosure: Paula S. Katz has disclosed no relevant financial relationships.

CME Author

  • Laurie Barclay, MD

    Freelance writer and reviewer
    Medscape, LLC

    Disclosures

    Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.

Editor

  • Lois Snyder Sulmasy, JD

    Director
    Center for Ethics and Professionalism
    American College of Physicians
    Philadelphia, Pennsylvania

    Disclosures

    Disclosure: Lois Snyder Sulmasy, JD, has disclosed no relevant financial relationships.

CME Reviewer

  • Amy Bernard, MS, BSN, RN-BC, CHCP

    Director, Accreditation and Compliance
    Medscape, LLC

    Disclosures

    Disclosure: Amy Bernard, MS, BSN, RN-BC, CHCP, has disclosed no relevant financial relationships.

The planning for this activity began in 2019, prior to full implementation of the 2022 Standards. Our transition to the 2022 Standards was in place at the time of renewing this activity. Planning actions for obtaining disclosures from those in control of content, occurred prior to our organization's full implementation of the new Standards.


Accreditation Statements

Medscape

 
Interprofessional Continuing Education

In support of improving patient care, Medscape, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

    For Physicians

  • The case history and commentary were developed by the American College of Physicians.

    Medscape, LLC designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.25 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

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For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]


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This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

Follow these steps to earn CME/CE credit*:

  1. Read the target audience, learning objectives, and author disclosures.
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CME / ABIM MOC

When the Family Caregiver Is a Physician: Negotiating the Ethical Boundaries

Authors: Case History and Commentary by Sheryl Mitnick, MPH, RN, and Lois Snyder Sulmasy, JDFaculty and Disclosures

CME / ABIM MOC Released: 2/21/2020; Reviewed and Renewed: 2/6/2023

Valid for credit through: 2/6/2024, 11:59 PM EST

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Case History

Dr Walsh's mother has been experiencing a loss of appetite and increasing weakness over the past few months. Although Dr Walsh had gently encouraged her mother to call her primary care physician, it wasn't until Mrs Walsh's friends remarked on her weight loss that she finally scheduled an appointment. Initial workup revealed elevated liver function tests and a 4.5-cm abdominal mass.

Dr Walsh, a rheumatologist, wants her mother to be evaluated and treated at the university health system where she practices. Mrs Walsh, her husband, and her 2 other children are reassured by the thought that Dr Walsh will be able to keep a close eye on Mrs Walsh's care. With her mother's permission, Dr Walsh contacted her friend and colleague, Dr Golden, a medical oncologist, who agreed to coordinate a workup for Mrs Walsh with the multidisciplinary team.

Although Dr Walsh is relieved that her mom will be receiving medical care at her health system, she questions the specifics of her own role in facilitating her mother's care. The American College of Physicians (ACP) Ethics Manual, seventh edition,[1] clearly stresses the need for caution in providing direct care to family and friends, noting that the role of advisor is permitted. But how should this be implemented? As a medical professional who is very familiar with her mother's medical history, Dr Walsh can quickly recognize subtle changes in her condition. She wants to use her knowledge and experience to benefit her mother but not to interfere with the medical team. How will she negotiate the boundaries between being her mother's family caregiver and advocate vs assuming the responsibilities of a treating physician? Dr Walsh decides to address her questions and concerns to Dr Golden, the physician who will be coordinating her mother's care.