title: Polarities in Clinical Thinking and Practice.
abstract: This analysis of a case of a bereaved patient that poses two treatment options-watchful waiting or medication-focuses on five "polarities" in clinical practice: (1) the normal and the pathological, (2) the individual and the diagnostic collective, (3) the primary care physician and the consultant, (4) the expert and nonexpert, and (5) the moment and the process. These polarities can accentuate ethical problems posed by this case, for example, by creating stark contrasts that mask the complex contexts of care and characteristics of patients. These stark contrasts can create false dilemmas that may obscure simpler, shared decision-making solutions. Alternatives to conceiving cases in terms of polarities are discussed.
authors.affiliation: Daniel W. Foster, MD Professor of Medical Ethics and a professor of psychiatry and clinical sciences at the University of Texas Southwestern Medical Center in Dallas, and an attending psychiatrist at the affiliated Parkland Behavioral Health Center and an ethics consultant for Parkland Health and Hospital Systems.
authors.forename: John Z
authors.initials: JZ
authors.lastname: Sadler
mesh_terms: D000368:Aged; D001601:Bereavement; D000066491:Clinical Decision-Making; D003253:Consultants; D003657:Decision Making; D003863:Depression / Q000175:diagnosis* / Q000188:drug therapy; D006117:Grief; D006801:Humans; D008297:Male; D000069342:Medical Overuse; D062528:Medicalization; D010817:Physician-Patient Relations; D010820:Physicians; D013850:Thinking; D057832:Watchful Waiting