How Situational Diagnosis Helps Disentangle Ethical and Psychological Features of Complex Cases

We review Marguerite S. Lederberg's 1999 Acta Oncologica article entitled "Disentangling Ethical and Psychological Issues: A Guide for Oncologists," in which she introduces a method of analysis that facilitates clarification of ethical and psychological aspects of complex cases. Based on her understanding of the dynamics at play in patients', family members', and physicians' experiences, Lederberg formulated what she calls "situational diagnosis," a guide on how to distinguish ethical from psychological issues at the bedside or when an ethics consultation is requested. Here, we apply situational diagnosis to a case and consider whether and how Lederberg's guidance relates to current literature on how clinicians communicate with patients about serious illnesses.