Patients and families are increasingly turning to crowdfunding to help them cover the cost of medical care. The ethics of crowdfunding has garnered some attention in the bioethical literature. In this paper I examine an ethical aspect of medical crowdfunding (MCF) that has received limited attention: the role of donors. I defend a virtue ethical approach to analyzing the role of donors in MCF. Vicious donation, where donors do not exercise the relevant virtues, can compound (...) some of the ethical risks associated with MCF, as seen in the several recent, high‐profile cases. My primary contention in this paper is that encouraging donors to think about how donating to a particular campaign would measure against the virtues I outline could help to discourage acts of ethically problematic donation to MCF campaigns. (shrink)

Larry Temkin draws on the work of Angus Deaton to argue that countries with poor governance sometimes rely on charitable giving and foreign aid in ways that enable them to avoid relying on their own citizens; this can cause them to be unresponsive to their citizens’ needs and thus prevent the long-term alleviation of poverty and other social problems. I argue that the implications of this “lack of government responsiveness argument” (or LOGRA) are both broader and narrower than they might (...) first appear. I explore how LOGRA applies more broadly to certain types of charitable giving in developed countries, with a focus on medical crowdfunding. I then highlight how LOGRA does not apply to charitable giving aimed at alleviating the suffering of the absolutely politically marginalized, or those especially vulnerable people to whom governments are never responsive. (shrink)

Medical crowdfunding has become a popular choice worldwide for people with unaffordable health needs. In low-income and middle-income countries with limited social welfare arrangements and a high incidence of catastrophic health spending, the market for medical crowdfunding is booming. However, relevant research was conducted exclusively in North America and Europe; little is known about medical crowdfunding activities inother contexts. As a first step towards filling this knowledge gap, this study depicts the realities of (...) class='Hi'>medical crowdfunding in a middle-income country China through empirical investigation and ethical analysis. We examine 100 randomly selected medical campaigns from a major Chinese crowdfunding platform and analyse the relevance of the previously identified ethical concerns to the Chinese context. The empirical findings show that Chinese campaigns have low and uneven success rates, require legally the participation of charitable organisations and focus on financial distress and family values in appealing for donations. In addition, the ethical analysis suggests that medical crowdfunding in China shares several ethical concerns raised in developed countries such as the veracity of claims and privacy violation. More importantly, our research reveals the inadequacy of current evidence and the lack of indicators to evaluate ethical issues in practice. Additional research is needed to better understand this fundraising practice across different social and cultural contexts. (shrink)

Medical crowdfunding has raised many ethical concerns, among them that it may undermine privacy, widen health inequities, and commodify health care. One motivation for medical crowdfunding has received particular attention among ethicists. Recent studies have shown that many individuals are using crowdfunding to finance access to scientifically unsupported medical treatments. Recently, GoFundMe prohibited campaigns for antivaccination groups on the grounds that they “promote misinformation about vaccines” and for treatment at a German clinic offering unproven (...) cancer treatments due to “the need to make sure people are equipped to make well‐informed decisions.” GoFundMe has not taken any additional actions to regulate the much larger presence of campaigns seeking to fund unproven medical interventions on the platform. In this article, we make the ethical case for intervention by GoFundMe and other crowdfunding platforms. (shrink)

Patients are increasingly turning to medical crowdfunding as a way to cover their healthcare costs. In the case of Charlie Gard, an infant born with encephalomyopathic mitochondrial DNA depletion syndrome, crowdfunding was used to finance experimental nucleoside therapy. Although this treatment was not provided in the end, we will argue that the success of the Gard family’s crowdfunding campaign reveals a number of potential ethical concerns. First, this case shows that crowdfunding can change the way (...) in which communal healthcare resources are allocated. Second, within the UK’s National Health Service, healthcare is ostensibly not a market resource; thus, permitting crowdfunding introduces market norms that could commodify healthcare. Third, pressures inherent to receiving funds from external parties may threaten the ability of patients-cum-recipients to voluntarily consent to treatment. We conclude that while crowdfunding itself is not unethical, its use can have unforeseen consequences that may influence conceptions of healthcare and how it is delivered. (shrink)

BackgroundSocial media has globalised compassion enabling requests for donations to spread beyond geographical boundaries. The use of social media for medical crowdfunding links people with unmet healthcare needs to charitable donors. There is no doubt that fundraising campaigns using such platforms facilitates access to financial resources to the benefit of patients and their caregivers.Main textThis paper reports on a critical review of the published literature and information from other online resources discussing medical crowdfunding and the related (...) ethical questions. The review highlighted the benefits of crowdfunding as well as the under-exploration of the risk of having patients’ desires and human rights undermined during online fundraising campaigns. Majority of these campaigns get initiated on behalf of the patients, especially the very sick and dependant. The ethical questions raised relate to the voluntariness of informed consent and the possibility of patients being used as a means to an end. Vulnerability of patients may expose them to coercion, undue influence, manipulation, and violation of their human rights. The success of these campaigns is influenced by the digital skills, pre-existing social networks and, the emotional potency. Healthcare is a public good, and online market forces should not determine access to essential health services. The benefits of crowdfunding cannot be subverted, but it can perpetuate unintended injustices, especially those arising from socio-economic factors.ConclusionsPolicymakers ought to monitor the utilisation of crowdfunding sites to identify policy failures and unmet essential health care needs responsible for driving individuals to use these platforms. The upholding of human rights and the fundamental respect of the individual’s wishes is a moral imperative. The need for an ethics framework to guide different stakeholders during medical crowdfunding needs further examination. (shrink)

Perceived trust is a key factor affecting the behavior to donate online. In order to further explore the factors and influencing mechanisms that affect the success of medical crowdfunding projects, this paper, combined with the Stimulus-Organism-Response theory, introduces the mediating variable of social presence and perceived differences in trust, and constructs a model of online users’ donation behavior to medical crowdfunding projects. We collected 437 valid samples through a questionnaire survey, and processed the data with SPSS (...) and Amos software to test and analyze the theoretical model. The research results showed that project description and user participation have a significant positive effect on social presence; project transparency and patient identity have a significant negative effect on perceived differences in trust; social presence has a positive effect on donation behavior, while the perceived difference in trust has a negative effect; social presence and perceived differences in trust play a mediating role respectively; there is no significant effect of patient status on social presence. This study further expands the application of social presence and perceived differences in trust in medical crowdfunding, and provides a theoretical basis for the success of medical crowdfunding projects. (shrink)

When people use online platforms to solicit funds from others for health-related needs, they are engaging in medical crowdfunding. This form of crowdfunding is growing in popularity, and its visibility is increasing as campaigns are commonly shared via social networking. A number of ethical issues have been raised about medical crowdfunding, one of which is that it introduces a number of privacy concerns. While campaigners are encouraged to share very personal details to encourage donations, the (...) sharing of such details may result in privacy losses for the beneficiary. Here, we explore the ways in which privacy can be threatened through the practice of medical crowdfunding by exploring campaigns for children with defined health needs scraped from the GoFundMe platform. We found specific privacy concerns related to the disclosure of private details about the beneficiary, the inclusion of images and the nature of the relationship between campaigner, funding recipient and beneficiary. For example, it was found that identifying personal and medical details about the beneficiary, including symptoms and treatment history, were often mentioned by campaigners. While the privacy concerns identified are problematic, they are also difficult to remedy given the strong financial incentive to crowdfund. However, crowdfunding platforms can enhance privacy protections by, for example, requiring those campaigning on behalf of child beneficiaries to ensure consent has been obtained from their guardians and providing additional guidelines for the inclusion of personal information in campaigns made on behalf of those not able to give their consent to the campaign. (shrink)

Crowdfunding websites allow users to post a public appeal for funding for a range of activities, including adoption, travel, research, participation in sports, and many others. One common form of crowdfunding is for expenses related to medical care. Medical crowdfunding appeals serve as a means of addressing gaps in medical and employment insurance, both in countries without universal health insurance, like the United States, and countries with universal coverage limited to essential medical needs, (...) like Canada. For example, as of 2012, the website Gofundme had been used to raise a total of 8.8 million dollars for seventy-six hundred campaigns, the majority of which were health related. This money can make an important difference in the lives of crowdfunding users, as the costs of unexpected or uninsured medical needs can be staggering. In this article, I offer an overview of the benefits of medical crowdfunding websites and the ethical concerns they raise. I argue that medical crowdfunding is a symptom and cause of, rather than a solution to, health system injustices and that policy-makers should work to address the injustices motivating the use of crowdfunding sites for essential medical services. Despite the sites’ ethical problems, individual users and donors need not refrain from using them, but they bear a political responsibility to address the inequities encouraged by these sites. I conclude by suggesting some responses to these concerns and future directions for research. (shrink)

Crowdfunding is increasingly common in medical research. Some critics are concerned that by adopting crowdfunding, some researchers may sidestep the established systems of review of the social and scientific value of studies, especially mechanisms of expert-based review. I argue firstly that such concerns are based on a misleading picture of how research value is assessed and secondly that crowdfunding may turn out to be an useful complement of extant funding systems. I start with the idea that (...) medical knowledge is a structured and intermediate public good and explain from this perspective that funding systems as a whole, rather than any of their parts ought to be considered devices for the discovery of the social and scientific value of research. If so, we should not be concerned with whether crowdfunding bypasses expert reviews, but with whether it may constitute an improvement of extant funding systems. In the second part, I speculate that crowdfunding may ameliorate, albeit limitedly, some recalcitrant failures of funding systems, such as the sponsorship of research on neglected diseases, and smooth funding adaptations for scientific transitions. If, after trial, such hypotheses turn out to be true, crowdfunding ought to be promoted. (shrink)

Public welfare fundraising has been used to collect donations for medical supplies and has played an important role in the fight against the COVID-19 pandemic. This paper studies online crowdfunding donations from the Alumni Association of Wuhan University to North American alumni; donation data are used to investigate how individuals' donation behavior is affected by the previous donation amount and information provided by the fundraising platform. First, our results show that one's donation amount is positively affected by the (...) previous donation amount. Second, the donor's positive sentiment in the message that he or she leaves, as measured by either natural language processing or a manual rating, can affect the subsequent anonymity and messages but not the subsequent donation amount. Third, anonymous donations are much smaller than non-anonymous donations. (shrink)

In the current issue of The New Atlantis, Daniel Sarewitz, professor of science and society at Arizona State University, argues that science is broken because it is managed and judged by scientists themselves, operating under Vannevar Bush's famous 1945 declaration that scientific progress depends on the “free play of free intellects … dictated by their curiosity.” With that scientific agenda, society ends up with a lot of unnecessary, uncoordinated, and unproductive research. To save science, holds Sarewitz, we need to put (...) it in the hands of people who are looking for practical solutions to specific problems. In one article in this issue of the Hastings Center Report, Kirstin Borgerson poses a question in this same conceptual space: are there too many clinical trials? Other pieces in the issue cover a mix of topics: the lead article addresses some of the challenges that will have to be faced as “artificial organs” become available, a third article looks at how crowdfunding sites like GoFundMe can be used to make public appeals for medical funding, and a special report found in a supplement to the issue offers a round of analysis and recommendations about the provision of medical care to professional football players. (shrink)

We write in response to the original article by Rennie and Rudland published in the April 2003 edition of this journal.1 Current and former Dundee Medical School students are concerned at the media misinterpretation of the study and the consequences that this branding of “dishonesty” will have on Dundee Medical School’s reputation and also on individuals embarking on their ….

This code of practice for health professionals was prepared by a multi-professional group and reflects good clinical practice in encouraging dialogue about individuals' wishes concerning their future treatment. It has a broad practical approach, considers a range of advance statements, advises of dangers and benefits of making treatment decisions in advance and combines annotated code of practice with a quick pull out guide for easy reference.

This article presents an analysis of contractual relations in sport from the standpoint of the Croatian legislative system. Due to the complexity of the subject matter, the author considers only a small fragment of it - the significance and the role of sport in Croatian society and the law of contracts „as a cornerstone on which „sports law“ has been built and which is of primary importance in most areas where there is an interface between sport and the law, irrespective (...) of whether the sport is being played at an elite level or at a more humble one“. Bearing in mind the limited extent of this article, the autor tries to provide some clarifications and some guidance on how to deal with the designation and the determination of the applicable law for contracts in the sporting context. Considering that there are different legal regimes which may come into play with regard to the designation of the law applicable to contracts in the sporting context, the author first presents the determination of the applicable law according to the Rome I Regulation and then according to the Croatian Arbitration Act, Swiss Private International Law Act and the CAS Code of Sports-related Arbitration, as the most common in sports practice. Then, the author deals with contracts concluded with minor athletes and the determination of the law applicable to some preliminary questions. Finally, the author presents her perception of the problems encountered and some suggestions for the improvement of the existing legal framework. (shrink)

Summary Principles Timely support for patients and people close to them, and effective, sensitive communication are essential. Decisions must be based on the individual patient's circumstances and reviewed regularly. Sensitive advance discussion should always be encouraged, but not forced. Information about CPR and the chances of a successful outcome needs to be realistic. Practical matters Information about CPR policies should be displayed for patients and staff. Leaflets should be available for patients and people close to them explaining about CPR, how (...) decisions are made and their involvement in decisions. Decisions about attempting CPR must be communicated effectively to relevant health professionals. In emergencies If no advance decision has been made or is known, CPR should be attempted unless: the patient has refused CPR; the patient is clearly in the terminal phase of illness; or the burdens of the treatment outweigh the benefits. Advance decision making Competent patients should be involved in discussions about attempting CPR unless they indicate that they do not want to be. Where patients lack competence to participate, people close to them can be helpful in reflecting their views. Legal issues Patients' rights under the Human Rights Act must be taken into account in decision making. Neither patients nor relatives can demand treatment which the health care team judges to be inappropriate, but all efforts will be made to accommodate wishes and preferences. In England, Wales and Northern Ireland relatives and people close to the patient are not entitled in law to take health care decisions for the patient. In Scotland, adults may appoint a health care proxy to give consent to medical treatment. Health professionals need to be aware of the law in relation to decision making for children and young people.IntroductionWhy policies are neededCardiopulmonary resuscitation can be attempted on any person whose cardiac or respiratory functions cease. Failure of these functions is part of dying and thus …. (shrink)

1. Aim of the guidelines2. Principles of good practice3. Circumcision for medical purposes4. Non-therapeutic circumcision 4.1. The law 4.1.1. Summary: the law 4.2. Consent and refusal 4.2.1. Children’s own consent 4.2.2. Parents’ consent 4.2.3. Summary: consent and refusal 4.3. Best interests 4.3.1. Summary: best interests 4.4. Health issues 4.5. Standards 4.6. Facilities 4.7. Charging patients 4.8. Conscientious objection5. Useful addresses.

One of the key criticisms of understanding health in terms of adaptation to one’s environment is that medical judgments should be able to apply across environments. If we say that a condition is pathological ‘for person X in environment E’, then we quickly run into problems of desirability and social values. However, many key concepts in biology entail an inability to separate the organism from its environment. In other words, it is precisely by referring to ‘organism X in environment (...) E’ that we can determine what is ‘normal and natural’. In this chapter, I will argue that the role of this inseparability of organism and environment for understanding medical norms has been misunderstood and the implications of it for naturalistic theories of health and disease have gone largely unappreciated. To better understand this contextualist approach, I will discuss the ideas of John Ryle and Georges Canguilhem, focusing primarily on the latter. In Canguilhem’s work we find some key arguments for why organismic norms need to be understood relative to environments and how this can help to clarify the concepts of health and disease. I will explore his peculiar form of naturalism that was based on the dynamism and variability of organisms, show how it can be clarified through more recent biological research, and mention some of its limitations. (shrink)

Ancient medical and healing systems are currently attracting considerable interest. This issue includes interdisciplinary studies which focus on new perceptions of some ancient and medieval medical systems, exploring how they related to each other, and assessing their contribution to modern society. It is shown that pre-Greek medicine included some rational elements, and that Egyptian and Babylonian medical systems contributed to a tradition which led from classical antiquity through the Middle Ages and beyond. The reliability of sources of (...) evidence is considered, as well as the legacy of the ancient healing environments and disease treatments. Finally, where documentation survives, the legacy of social attitudes to health and disease is considered. Overarching principles directed policies of social medicine and healthcare in antiquity and the Middle Ages: for example, the causes and transmission routes of infectious diseases, as well as the basic principles of sterilization, were unknown, but nevertheless attempts were made to improve sanitation, provide clean water, and ensure access to trained physicians. In some cases, the need to limit the size of the population prompted the use of contraceptive measures, and surviving information also illuminates attitudes to deformity, disability and the treatment of the terminally ill. (shrink)

Background Truth-telling in health care is about providing patients with accurate information about their diagnoses and prognoses to enable them to make decisions that can benefit their overall health. Physicians worldwide, especially in the United Kingdom (U.K.) and the United States (U.S.), openly share such medical information. Bangladesh, however, is a Muslim-majority society with different social norms than Western societies. Therefore, we examined whether Muslim culture supports truth disclosure for patients, particularly how and to what extent medical information (...) about life-threatening diseases is provided to patients in Bangladesh. Methods This was a phenomenological qualitative study. We conducted thirty in-depth interviews with clinicians, nurses, patients and their relatives at Shaheed Suhrawardy Medical College Hospital in Dhaka, Bangladesh. We also used observations to explore interactions between patients, families and healthcare professionals regarding their involvement in medical decisions and truth disclosure issues. NVivo software was used to identify common themes, and a thematic analysis method was utilised to analyse the datasets. Results This study identified three recurring themes relevant to the ethics and practice of truth disclosure: best interest rather than autonomy, the ambivalent value of deception and who understands what. The participants revealed that physicians often withhold fatal medical prognoses from terminally ill patients to ensure the best healthcare outcomes. The results indicate that deception towards patients is commonly accepted as a means of reducing burden and providing comfort. The participants opined that true medical information should be withheld from some patients, assuming that such disclosures may create a severe burden on them. Whether or to what extent medical information is disclosed primarily depends on a family’s wishes and preferences. Conclusions While truth disclosure to patients is considered an ethical norm in many cultures, such as in the U.K. and the U.S., the practice of concealing or partially revealing severe medical prognoses to patients is an actual medical practice in Bangladeshi society. This study emphasises the importance of recognising a patient’s active involvement and respecting the cultural values that shape family involvement in medical decision-making. These findings may have significant policy and practical implications for promoting patient autonomy within Bangladeshi family dynamics and religious-based cultural values. (shrink)

Medical ethics education is crucial for medical students and trainees, helping to shape attitudes, beliefs, values, and professional identities. Exploration of ethical dilemmas and approaches to resolving them provides a broader understanding of the social and cultural contexts in which medicine is practiced, as well as the ethical implications of medical decisions, fostering critical thinking and self-reflection skills imperative to providing patient-centered care. However, exposure to medical ethics topics and their clinical applications can be limited by (...) curricular constraints and the availability of institutional resources and expertise. Podcasts, among other Free Open Access Medical Education (FOAMed) resources, are a novel educational tool that offers particular advantages for self-directed learning, a process by which learners engage in asynchronous educational opportunities outside of traditional academic or clinical settings. Podcasts can be readily distributed to wide audiences and played at any time, reducing barriers to access and offering a level of flexibility that is not possible with traditional forms of education and is well-suited to busy schedules. Podcasts can also use real voices and storytelling to make the content memorable and eminently human. This paper describes the development, production process, and impact of Core IM’s “At the Bedside,” a podcast focusing on issues in medical ethics and the medical humanities, intending to supplement standard bioethics curricula in an accessible, relevant, and engaging way. The authors advocate for broad incorporation of podcasts into medical ethics education. (shrink)

In the film Never Let Me Go, clones are forced to donate their organs anonymously. As a work of fiction, this film can be regarded as a negotiation of limited agency, since the clones are depicted as vulnerable individuals. Thereby, it evokes a confrontation with underprivileged positions in technocratic societies, encouraging the audience to take the perspective of the marginalised. The clones are situated in ‘privileged deprivation’; from the audience’s point of view, they are unable to evolve into autonomous agents—but (...) from their own perspective within the dystopian system, they are still ‘privileged’. In this paper, we analyse the depiction of the clones’ personal development. Further, we examine references to bioethical aspects as well as technologies that affect the human body both on a micro and macro level—cloning and its impact on the human embryo and organ donation practised on the full-grown human body. We argue that this film as a reference for the discussion in popular culture focuses on individuals who do not profit from modern technical progress or do not have enough agency to refuse it. To make this point, we analyse the film’s fictional story, set in a form of alternate history, as a negotiation of a historical context which brings out the idea of neglected voices. (shrink)

Redefining, redrawing, and resetting the respective domains of philosophy, medicine, and health care, this book provides a conceptual point of departure from which the radical changes that will be required of health care in the next century can be envisioned and acted upon. It provides critical analyses of the conceptual apparatus that informs the many dimensions of health care practices, challenging the fundamental relationships of authority that exist between patients and health care practitioners, questioning the tradition of using classical ethical (...) theories within the domain of health care, and suggesting a set of different directions in which health care should develop. (shrink)

In November of 1959, William Bean published in the Archives of Internal Medicine a scathing review of Félix Martí-Ibañez’s Centaur: Essays on the History of Medical Ideas. Martí-Ibañez and Bean were two of the leading exponents of the importance of medical humanism during a formative period from the 1950s through the 1970s. But the two physicians differed fundamentally in their views of the ideal relationships among the pharmaceutical industry, the medical profession, and the medical humanities. We (...) situate Bean’s review within its historical context, shedding light on the history and diverging uses of the medical humanities. (shrink)

For a number of reasons, casuistry has come into vogue in medical ethics. Despite the frequency with which it is avowed, the application of casuistry to issues in medical ethics has been given virtually no systematic defense in the ethics literature. That may be for good reason, since a close examination reveals that casuistry delivers much less than its advocates suppose, and that it shares some of the same weaknesses as the principle-based methods it would hope to supplant.

Vitalism, from its early modern to its Enlightenment forms (from Glisson and Willis to La Caze and Barthez), is notoriously opposed to intervention into the living sphere. Experiment, quantification, measurement are all ‘vivisectionist’, morally suspect and worse, they alter and warp the ‘life’ of the subject. They are good for studying corpses, not living individuals. This much is well known, and it has disqualified vitalist medicine from having a place in standard histories of medicine, until recent, post-Foucauldian maneuvers have sought (...) to change the situation (but for unrelated, contextualist reasons). What is perhaps more suprising is that if we consider the emergence of medical ‘theory’ as a whole, from Harvey through to Locke and Sydenham, is the presence of a sustained anti-experimentalist line of argument, and this from the ‘empiricist’ (not Cartesian or Boerhaavian rationalist) side. It would seem then that ‘empiricks’, medical empiricists and other protagonists of an ‘embodied empiricism’ are not Boylean experimentalists who seek to map out Nature in its transparency, but deliberately archaic, Hippocratic observers of living bodies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Navigating Hard Situations that Medical School Cannot Prepare You ForJenna BennettI imagined my first experience with grief as a medical student would be peaceful and measured, prompted by the quiet and peaceful [End Page 88] passing of an elderly individual who lived a long life, surrounded by loving family members comforting each other and reminiscing. Of course, I knew things would get harder—I just didn't expect it (...) to be during my first clinical experience as a medical student.My vision for my first experience with grief as a medical student was idealistic, but I was not unfamiliar with grief on a professional or personal basis. Prior to medical school, I was an aide at a long-term care facility. Many patients were on hospice, so end-of-life care and conversations took place daily without fear or shame. Deaths in this setting had happened as I envisioned—a natural course after a long life. Most of the time, the patients and their families were prepared and accepting. It was, of course, a somber occasion no matter how prepared everyone was, but death was almost never unexpected or met with anything other than tearful acceptance. As an aide, I felt honored to provide care at the end of one's life.In my personal life, I had similarly lost elderly family members. Although it was upsetting to have my loved ones pass away, no matter how much time we had to prepare, my family and I were never blind-sided and had time to discuss final wishes and cherish time together; however, for my family, there was one exception to this. When I was young, my father unexpectedly passed away from a heroin overdose. He was alone when he died, not even 30 years old.For a long time, I was ashamed of my father's death. I was very young, and I didn't understand the nature of addiction. I was angry, confused, and embarrassed. As a result, I created my own version that I thought was more palatable, for years telling everyone he had passed away surrounded by a loving family after a long battle with lung cancer.Over the years, I came to terms with my father's death. I learned that substance use is a disease, not a choice. I forgave my dad, along with eventually also forgiving myself for my years of denial and shame. His struggles and death ended up being a large motivation to pursue a career in the medical field, along with being a key part of my identity that I no longer hesitate to share. Despite having matured in this way long before starting medical school, I now recognize I still had some lingering rejection of the wide reality of tragedies that exist in our world.My first clinical experience as a medical student was a 3-week rotation with pediatric hospitalists. By the halfway point of this rotation, I was having a great time and was excited to finally be working with patients after months of sitting in lecture halls and late nights in the library. Of course, all the children we saw were sick, which was hard to see, but all the patients either had viral infections or chronic, but usually non-life-threatening, conditions. Therefore, everyone in our service rapidly improved with minimal interventions, and almost everyone was able to go home after just a few days. I was also encouraged by how loving and knowledgeable all of the family members of the patients were. Even when family members were upset and occasionally took frustrations out on the physicians I was working with, I was not shaken and empathized entirely, as I knew the families' reactions resulted from love and concern for their children. Overall, these initial experiences with patients and their families maintained my optimism that things wouldn't get emotionally hard for me anytime soon, but life, and subsequently medicine, do not wait for you to be ready.I was chatting with my attending one morning toward the latter half of this rotation. Another care team came into our small workroom, which was not unusual, but I could immediately tell something was different... (shrink)