How Social Media Verdicts Could Upend Tech Industry

 by Jacob Burg via The Epoch Times,

Two major court verdicts last week finding social media giants Meta and YouTube liable for harm to users could send shock waves through the tech industry.

In a first-of-its-kind lawsuit, a jury in Los Angeles on March 25 found both companies liable for making their platforms addictive and deleterious to the mental health of young users.

The 20-year-old plaintiff, referred to as “Kaley G.M.” or only her initials K.G.M. during trial, testified that she had become addicted to social media at a young age and that it negatively affected her mental health.

Jurors ultimately decided that Meta was more liable for harming K.G.M., giving the tech giant 70 percent of the responsibility, or $2.1 million of the total $3 million in punitive damages, while YouTube shouldered 30 percent, or $900,000.

An additional $3 million in compensatory damages were recommended by jurors to be paid by Meta and YouTube—the only remaining defendants in the case after TikTok and Snap settled with K.G.M. before trial—after deciding they acted with malice, oppression, or fraud in harming children with their platforms.

In a separate case, jurors in New Mexico determined on March 24 that Meta had violated state law by failing to properly disclose risks to and protect children on its social media platforms. The case, brought by New Mexico Attorney General Raúl Torrez, resulted in a $375 million fine.

Prosecutor Linda Singer, who previously served as attorney general of the District of Columbia but now works in private litigation, had asked the jury to fine Meta $2 billion.

Former federal prosecutor Neama Rahmani called them “bellwether” cases.

“Obviously, these cases will absolutely go up on appeal,” he told The Epoch Times.

“I think they will likely end up before the Supreme Court, and how they view this issue will make or break Big Tech, because I think we’re going to see lots of copycat lawsuits, and the judgments and fines are going to rack up into the billions and billions of dollars.”

A person holds a sign referencing the 20-year-old plaintiff, identified in court as “Kaley G.M.” or by her initials K.G.M., as people wait for a verdict in the social media trial in Los Angeles on March 20, 2026. On March 25, a jury found both companies liable for making their platforms addictive and deleterious to the mental health of young users and ordered the companies to pay $3 million in damages. Patrick T. Fallon/AFP via Getty Images

While the cases reflect two different sets of accusations—addictive design on the one hand and failure to protect children on the other—both will likely invite a torrent of claims, said John Shu, a constitutional law expert who served in both Bush administrations.

“I think this will definitely open the litigation floodgates in California, and not just for individual lawsuits,” Shu told The Epoch Times. “It also opens the floodgates to class action lawsuits; that’s where the big money is.”

Addictive Design Versus Child Safety Issues

In the Los Angeles trial, jurors heard testimony from a range of witnesses, including therapists, adolescent addiction experts, executives, engineers, and whistleblowers.

The case highlighted the platforms’ design and operation, such as their “infinite scroll” features, beauty filters, and the companies’ proprietary algorithms that determine the type of content served to users.

Plaintiff attorney Mark Lanier did not target third-party content found on the platforms, which enjoys broad protection from the First Amendment and Section 230 of the 1996 Communications Decency Act.

Instead, he argued that the tech giants preyed on their vulnerable teen users in pursuit of money and power, comparing them to lions stalking wounded gazelles on the Serengeti.

Plaintiffs’ attorney Mark Lanier (C) speaks to reporters outside the Los Angeles Superior Court in Los Angeles on March 25, 2026. Frederic J. Brown/AFP via Getty Images

In the New Mexico case, Torrez argued that Meta violated the state’s Unfair Practices Act by knowing about the potential danger its platforms presented to children and hiding it from the public.

His office had its investigators set up accounts on Meta’s platforms posing as minors, after which they began to receive sexually explicit images and messages from adult users.

Jurors ultimately found 37,500 violations under one subsection of New Mexico’s Unfair Practices Act and the same number under another. Since fines were limited to a maximum of $5,000 per violation, Meta was fined $375 million.

“It was pretty remarkable, because the jury came back quickly. And the conventional wisdom in these civil cases is that a quick verdict is usually a defense verdict,” Rahmani said, referring to a verdict that is given in favor of a defendant, often when the plaintiff or prosecutors are unable to prove their case.

Instead, jurors returned an “overwhelmingly plaintiff’s verdict in less than a day,” Rahmani said.

But Meta may be forced to do more after it defends itself during the follow-up hearing in May, which will determine whether the tech giant’s platforms created a public nuisance and whether it should be required to pay for public programs to address harms to users.

Accusing Meta of creating a public nuisance with its digital social media platforms is a novel use of the law, Shu said.

“The historical tradition of public nuisance is tied to land or real estate,” he said, using the example of a landowner being required to remove a fallen tree blocking a public road at the threat of fines from a state or municipal government.

Lawyer Matthew Bergman of the Social Media Victims Law Center speaks to the press as survivor parents Amy Neville, Julianna Arnold, Deb Schmill, Judy Rogg, Toney Roberts, and Brandy Roberts stand outside the Los Angeles Superior Court in Los Angeles on Feb. 18, 2026. Jill Connelly/Getty Images

“This is a novel use of public nuisance. But if they convince a judge to do it, that’s going to open the door to massive payouts, not in actual damages, but in so-called ‘abatement costs,’” Shu said. “Because the state attorney general represents all of New Mexico’s 2.1 million citizens, they and their private sector mass-tort plaintiffs lawyers can ask for billions of dollars.”

That’s because in a public nuisance hearing, the awarded damages would not be based on individual violations of the law, but instead applied to the number of citizens in the state.

Critically, both verdicts only require the companies to pay out monetary damages—neither requires either company to change or alter the design or operations of their platforms. That may change for Meta after its May hearing in the New Mexico case.

Meta, Google Deny Allegations

Both Meta and Google, which owns YouTube, have denied that their platforms are designed to be addictive.

“We disagree with the verdict and plan to appeal,” Jose Castañeda, a Google spokesperson, said in a statement to The Epoch Times. “This case misunderstands YouTube, which is a responsibly built streaming platform, not a social media site.”

Meta said it respectfully disagrees with the two verdicts and plans to appeal.

“Reducing something as complex as teen mental health to a single cause risks leaving the many, broader issues teens face today unaddressed and overlooks the fact that many teens rely on digital communities to connect and find belonging,” a company spokesperson said in a statement to The Epoch Times.

“We remain committed to building safe, supportive environments for young people and will defend our record vigorously.”

Meta also highlighted the fact that the jury in the California case awarded $3 million in punitive damages after the plaintiff’s counsel had sought more than a billion.

Attorney Luis Li, representing YouTube and Google, arrives at Los Angeles Superior Court during the social media trial in Los Angeles on March 25, 2026. Both Meta and Google, which owns YouTube, have denied that their platforms are designed to be addictive and plan to appeal. Frederic J. Brown/AFP via Getty Images

Future Litigation Potential

Sen. Richard Blumenthal (D-Conn.) said he noticed similarities between the two social media cases and those he’d previously litigated against the tobacco industry.

“Both [Big Tobacco and Big Tech] have made products with lethal design defects—leading to destructive addiction. Tobacco exploited nicotine’s grip, Big Tech used infinite scrolling, & a myriad of other devices,” he wrote on social media.

“Both have targeted children—relentlessly & reprehensibly—putting profits over public health, promoting generational addiction & harm.”

Shu said social media litigators may follow a similar playbook used against Big Tobacco by first suing based on alleged harms to children before widening the scope to all users of the companies’ products.

“Once they’ve established liability for kids, instead of saying, ‘Well, adults use cigarettes too,‘ now they’re going to say, ’Well, adults use Instagram and Snapchat too,’” he said. “So that’s where all this is headed next.”

Google is particularly vulnerable, Shu said, because it is responsible not only for YouTube, but also for Android, Gemini, and DeepMind, and it is the dominant search engine.

Sen. Richard Blumenthal (D-Conn.) participates in a forum at the U.S. Capitol on March 17, 2026. Blumenthal said he noticed similarities between the two social media cases and those he’d previously litigated against the tobacco industry. Kevin Dietsch/Getty Images

Braden Perry, a government investigations and corporate litigation attorney, said the verdicts provide regulatory agencies with a road map for pursuing future cases without requiring new legislation.

State attorneys general can also pursue consumer protection actions against tech companies, Perry told The Epoch Times.

Long-Term Impacts on Tech Industry

“If engagement-maximization features become liability risks, platforms will face pressure to redo their algorithms and interfaces to prioritize welfare over engagement metrics,” Perry said, adding that “good actors” in the industry may face more disadvantages than companies “who skirt or ignore the risks” or that are more “aggressive than others.”

He said the verdicts not only threaten Meta and Google, but also the “foundational assumption that technology companies bear no responsibility for their design choices.”

These are not the only ramifications for the tech industry.

The New Mexico case specifically goes “beyond addiction alone and raises broader questions about whether these platforms are reasonably safe for children and adolescents,” attorney Michael Ponce told The Epoch Times.

He said the growing body of scientific research describing how prolonged social media use may negatively impact mental health was critical in both cases.

Images of deceased children are displayed at the “Lost Screen Memorial,” an art installation of large-scale smartphones featuring 50 children who lost their lives due to social media harm online, in Los Angeles on Feb. 13, 2026. Frederic J. Brown/AFP via Getty Images

Additionally, the central allegation in the California case and many related lawsuits is that companies were aware of the risks but “nevertheless continued to design their platforms in a manner that prioritized user engagement,” Ponce said.

The two verdicts, and any future cases that draw inspiration from them, could “cripple” the tech industry and send a “warning” to social media companies, Shu said.

He said if prosecutors in other states—particularly one with a large population like California’s—decide to follow the same path as New Mexico, the abatement costs for the citizenry if a public nuisance ruling is granted are likely to be massive.

“This is one heck of a warning, it’s kind of like somebody opening up a fire hose on you to wake you up in the morning,” Shu said.

https://www.zerohedge.com/technology/how-social-media-verdicts-could-upend-tech-industry

Less Than Half Of Health Care Workers Received An Updated COVID-19 Vaccine: CDC

 by Zachary Stieber via The Epoch Times,

A minority of health care workers received an updated COVID-19 vaccine, according to a newly reported survey from the Centers for Disease Control and Prevention.

Just 40.2 percent of health care personnel who responded to the survey said they received a COVID-19 shot between the fall of 2024 and early 2025, CDC researchers said on April 2.

The rate of vaccination was higher, 76.3 percent, for influenza.

The survey was conducted online from March 26 to April 17 in 2025, following the 2024–2025 respiratory virus season. The season begins in the fall of each year and runs into the next year.

Some 2,650 health care workers responded to the survey.

At the time, the CDC recommended influenza and COVID-19 vaccination for virtually all Americans aged 6 months and older, regardless of the number of prior doses. The CDC more recently narrowed its recommendations for those shots, citing factors such as uncertain risk-benefit profiles.

A federal judge blocked the updates in March.

The percentage of workers who took a COVID-19 vaccine increased from the prior season, when the rate was 31.3 percent, according to the newly released survey. The percentage of workers who received a flu shot remained about the same, though it is down from years prior to the COVID-19 pandemic.

CDC researchers said the increase in COVID-19 vaccination coverage may be from the vaccine for the 2024–2025 season becoming available one month earlier than the preceding year.

Workers aged 18 to 29 were most likely to receive a COVID-19 vaccine. Personnel aged 60 and up were more likely to receive an influenza immunization.

According to survey data, nearly four in 10 employers required influenza vaccination, and about 14 in 100 mandated COVID-19 vaccination. People who worked for employers who required vaccination were far more likely to have received the vaccines. Some 83 percent of workers required to receive a COVID-19 vaccine had received one, compared to 46 percent whose employer recommended COVID-19 vaccination and just 19 percent whose employer did not require or recommend vaccination.

CDC researchers said that the data could “help guide the development and implementation of evidence-based strategies to encourage vaccination, increase coverage, reduce influenza incidence among [health care personnel] and their patients, and limit strain on the health care system.”

The researchers said the findings supported actively promoting vaccination in places of business to increase influenza vaccination coverage among health care workers.

Health care workers who decline vaccination have said in previous surveys that they were worried about vaccine side effects and expressed distrust in health authorities.

The CDC published the study in its quasi-journal, Morbidity and Mortality Weekly Report. The publication ensures reports align with CDC messaging and typically does not peer-review papers.

“Although most articles that appear in MMWR are not ‘peer-reviewed’ in the way that submissions to medical journals are, to ensure that the content of MMWR comports with CDC policy, every submission to MMWR undergoes a rigorous multilevel clearance process before publication,” the CDC said in a 2011 report. “By the time a report appears in MMWR, it reflects, or is consistent with, CDC policy.”

Limitations of the paper included the vaccination status being self-reported and unverified. Authors disclosed no potential conflicts of interest.

https://www.zerohedge.com/medical/less-half-health-care-workers-received-updated-covid-19-vaccine-cdc

Reclaiming our own birthright: We might need to amend the Constitution

 “Well, it’s a new world. It’s the same Constitution.”

Those words from Chief Justice John Roberts during this week’s oral arguments signaled that the conservative justices are unlikely to reject birthright citizenship. Of course, nothing is certain until this summer when the Court issues its opinion in Trump v. Barbara. However, we need to consider the need for a 28th Amendment to reaffirm the meaning of citizenship. 

 As some of us stressed before the oral argument, the odds were against the administration prevailing in the case, given more than a century of countervailing precedent. There are good-faith arguments against reading the 14th Amendment as supporting citizenship for any child born in this country. It is doubtful that the drafters of the 14th Amendment could have envisioned millions of births to illegal aliens. They surely did not imagine foreigners coming to this country for the purpose of giving birth — or even, without ever entering the U.S., contracting multiple U.S. residents to carry babies to term for them as surrogates.

The historical record is highly conflicted. Some drafters expressly denied that they intended for birthright citizenship to be covered by the 14th Amendment. 

The rampant abuse in this country and the widespread rejection of birthright citizenship by other countries (including some that once followed it) did not seem to impress the conservative justices. Roberts’s statement was in response to Solicitor General John Sauer’s argument that “We’re in a new world now … where eight billion people are one plane ride away from having a child who’s a U.S. citizen.”

Although President Trump has lashed out with personal attacks on the conservative justices as “disloyal” and “stupid,” they are doing what they are bound by oath to do: apply the law without political favor or interest. I expect most of the justices agree with the vast majority of countries — and the president — that birthright citizenship is a foolish and harmful policy. But they are not legislators; they are jurists tasked with constitutional interpretation.

Trump appointed three principled justices to the court. To their (and to his) credit, Justices Brett Kavanaugh, Neil Gorsuch and Amy Coney Barrett have proven that they are driven by the underlying law, not the ultimate outcome of cases.

For conservatives, constitutional interpretations offer less leeway than their liberal colleagues or believers in the “living constitution.” If you believe in continually updating the Constitution from the bench to meet contemporary demands, constitutional language is barely a speed bump on your path to the preferred outcome in any given case. 

In my Supreme Court class, I call this a “default case” in which justices tend to run home.  When a record or the law is uncertain, conservative justices tend to avoid expansive, new interpretations. That was precisely what Trump said he wanted in nominees.

These justices are not being “disloyal” to him, but rather loyal to what they view as the meaning of the Constitution. I have at times disagreed with their view of the law, but I have never questioned their integrity.

None of this means we should accept the expected outcome in this case as the final word on birthright citizenship. Justice Robert Jackson once observed that he and his colleagues “are not final because we are infallible, we are infallible because we are final.”

The final word actually rests with the public. We can amend the Constitution to join most of the world in barring birthright citizenship. There is no more important question in a republic than the definition of citizenship.

We are becoming a virtual mockery as we watch millions game the birthright citizenship system. China alone has hundreds of tourism firms that have made fortunes in arranging for Chinese citizens to come to U.S. territory to give birth and then return home.

No republic can last without controlling its borders and the qualifications for citizenship. We have allowed U.S. citizenship to become a mere commodity for the most affluent or unscrupulous among us.

The combination of open borders and open-ended citizenship is an existential threat to this Republic. 

The U.S. is and will remain a nation of immigrants. We welcome lawful immigrants who come to this country to embrace our values and our common identity. But being a nation of immigrants does not mean that we are a nation of chumps.

In my book, “Rage and the Republic: The Unfinished Story of the American Revolution,” I discuss the foundations of our republic and the world’s fascination with it. After our Revolution, one leading Frenchman known as John Hector St. John wrote a popular book that asked: “What then is the American, this new man?”

The answer to that question was obvious at our founding. We were the world’s first true enlightenment revolution — a republic founded on natural rights that came not from the government but God. We did not have a shared bond of land, culture, religion, or history. We were a people founded on a legacy of ideas; a people joined by common articles of faith in natural, unalienable rights.

The question is whether we can answer St. John’s challenge today. “What then is this American” if citizenship can be based on as little as a tourist visa or an illegal crossing? 

There would be no better time to reaffirm the meaning of citizenship than the 250th anniversary of our Constitution. Roberts is correct: “It is the same Constitution” that created this republic, but we are the same people vested with the responsibility, as Benjamin Franklin put it, “to keep it.”

It is time to reclaim both the Constitution and our common identity. As a free people joined by a common faith in natural rights, it is our own birthright.

Jonathan Turley is a law professor and the best-selling author of “Rage and the Republic: The Unfinished Story of the American Revolution.”

https://thehill.com/opinion/immigration/5815807-reclaiming-our-own-birthright-we-might-need-to-amend-the-constitution/

'Iran governor says US paratrooper reports in Iran are not true'

 Reports that US paratroopers were deployed by helicopter in the Charusa district of Kohgiluyeh County in southwestern Iran to rescue a missing US F-15E pilot are not true, the county governor Iraj Kazemijou said.

Earlier IRGC-affiliated Tasnim News reported that US paratroopers were seen in the area and had clashed with local forces

https://www.iranintl.com/en/liveblog/202604015564

'Reuters: Iran leaves door open for peace talks as hunt for missing US pilot continues'

 Iranian forces were hunting for a missing U.S. pilot on Saturday from one of two warplanes downed over Iran and the Gulf, raising the stakes for Washington as the war entered its sixth week with scant prospect of peace talks in sight.

The incidents show the risks still facing U.S. and Israeli aircraft over Iran, despite assertions by President Donald Trump and his Defense Secretary Pete Hegseth that U.S. forces had total control of the skies.

The prospect of a U.S. service member alive and on the run in Iran comes days after Trump threatened to bomb Iran “back to the Stone Ages” in a war that has killed thousands, sparked an energy crisis and threatened lasting damage to the world economy.

With Iran’s leadership defiant since the start of the war, its foreign minister in principle left the door open for peace talks with the U.S. via mediation from Pakistan, but gave no sign of Tehran’s willingness to bow to Trump’s demands.

“We are deeply grateful to Pakistan for its efforts and have never refused to go to Islamabad. What we care about are the terms of a conclusive and lasting END to the illegal war that is imposed on us,” Foreign Minister Abbas Araqchi said on X.

Trump on Saturday repeated his threats to intensify attacks on Iran if it failed to reach a deal, or open the key Strait of Hormuz waterway.

“Remember when I gave Iran ten days to MAKE A DEAL or OPEN UP THE HORMUZ STRAIT. Time is running out - 48 hours before all Hell will reign down on them. Glory be to GOD!” he said in a post on Truth Social.

As hostilities continued, Iran attacked an Israel-affiliated vessel with a drone in the Strait of Hormuz, setting the ship on fire, Iran’s state media said on Saturday, citing the commander of the Revolutionary Guards’ navy.

Iran has virtually shut the ​strait, which normally carries about a fifth of the world’s oil and liquefied natural gas.

IRAN TOUTS NEW AIR DEFENSE SYSTEMS

Iranian fire brought down a two-seat U.S. F-15E jet, officials in both countries said, while two U.S. officials said the pilot ejected from an A-10 Warthog fighter aircraft that crashed in Kuwait after being hit by Iranian fire.

Two Black Hawk helicopters engaged in the search for the missing pilot were hit by Iranian fire but made it out of Iranian airspace, the two U.S. officials told Reuters.

The scale of injuries to the crew was unclear.

Iran’s Revolutionary Guard Corps said it was combing a southwestern area near where the pilot’s plane came down, while the regional governor promised a commendation for anyone who captured or killed “forces of the hostile enemy.”

Iranians, pummelled by air power since the U.S. and Israel began their attacks on February 28, celebrated the plane downings.

The Khatam al-Anbiya joint military command said it used a new air defence system on Friday, which targeted a U.S. fighter jet, three drones and two cruise missiles.

“The enemy should know that we rely on new air defense systems built by the young, knowledgeable, and proud people of this country, unveiling them one after another in the field,” a Khatam al-Anbiya spokesperson said, according to Iran’s state media.

Iran’s Revolutionary Guards said they had targeted various areas in Israel in a wave of missiles and drones. They also targeted U.S. HIMARS rocket launcher batteries in Kuwait and Patriot missile batteries in Bahrain, according to a statement read on state TV.

Increasingly frustrated with the political fallout from the war, Trump is considering a broader cabinet shake-up in the wake of Attorney General Pam Bondi’s removal this week, people familiar with the discussions said.

Any potential reshuffling could serve as a reset for the White House as it confronts rising gas prices, falling ratings and worries for Republicans heading into November’s midterm elections.

“They’ve (U.S.) got themselves caught in a sort of double bind. If they simply leave, it’s really bad, and if they try to get the comprehensive defeat of Iran ... that looks really bad as well,” said Gareth Stansfield, a professor of Middle East politics at the UK’s Exeter University and senior fellow at the Atlantic Council.

“They’ve managed to get themselves into a lose-lose situation with this one.”

PETROCHEMICAL ZONE STRUCK IN IRAN

Iranian state media reported air strikes at a petrochemical zone in southwestern Iran, with five people reported injured so far.

A projectile also hit an auxiliary building near the perimeter of Iran’s Bushehr nuclear plant, the Tasnim news agency said, killing one person. The operations of the plant were unaffected.

Russia’s state nuclear company Rosatom evacuated a further 198 of its staff from the site on Saturday, Russian news agencies reported, in evacuations already planned before the latest incident.

The Israeli military meanwhile said it had carried out “a wave of strikes” on Tehran.

Israel has been waging a parallel campaign against Iran-backed Hezbollah in Lebanon after the militant group fired at Israel in support of Iran. Early on Saturday, Israel’s military said it was striking the militants’ infrastructure sites in Beirut.

https://www.militarytimes.com/news/pentagon-congress/2026/04/04/iran-leaves-door-open-for-peace-talks-as-hunt-for-missing-us-pilot-continues/

https://breakingthenews.net/Article/Iran:-Iraq-to-be-exempt-from-any-Hormuz-restrictions/66012655

'When Shared Decision-Making Becomes Medical Paternalism'

 "Why haven't they scheduled your dad for his feeding tube placement? They just want another family conference."

I sighed and told my mother we may have to fight. The physicians caring for my father seemed ready to overrule her decision, even though she held his medical power of attorney. When I spoke with an intern, I explained that our family had not changed its mind about the course of treatment. We simply wanted to know when the feeding tube would be placed.

Her response stunned me. "We refuse to place it," she said. "And we have the right to refuse anything."

Calmly, I explained that, as a physician myself, I know that doctors may decline to perform a procedure for ethical or professional reasons, but they are also obligated to transfer care or find someone willing to provide it. The ultimate decision about my father's treatment rested with our family -- specifically my mother.

What should have been a conversation about care became a confrontation about authority. Increasingly, families are finding that "shared decision-making" in medicine is giving way to something else: physicians overriding patient and family wishes in the name of "knowing what is best." Hospitals often promote "shared decision-making" as the ideal model of care. Yet, as debates about end-of-life treatment intensify, many families are discovering that the reality can feel very different.

Disagreements between families and medical teams are common, especially near the end of life. Physicians and families often face heartbreaking situations in which aggressive treatment may prolong suffering rather than improve quality of life. These are complex decisions, and families depend on clinicians for honest guidance and expertise.

But guidance is not the same as control.

Ideally, treatment decisions using shared decision-making emerge from mutual respect and open dialogue. In practice, however, the language of shared decision-making sometimes masks a different reality: families feel pressured to accept what clinicians believe is the correct decision.

Patients are routinely reminded that they have the right to refuse aggressive treatment. But what happens when a patient or family chooses the opposite -- to continue treatment despite a grim prognosis? Too often, autonomy seems to disappear when a patient or family chooses care that physicians would not choose themselves. I knew conversations were happening in the background in an effort to sway our decision.

Decisions about feeding tubes in patients with advanced dementia are among the most ethically complex choices families and physicians face. Studies suggest feeding tubes rarely improve survival or quality of life in these patients, which is why clinicians often hesitate to recommend them. But difficult medical evidence does not eliminate the need for respectful dialogue. Families may consider the same information and reach different conclusions based on personal, cultural, or religious values. The options presented to my family were not presented in a neutral fashion, which is what I aim to do in my practice.

This wasn't the first time our family encountered this attitude.

On another occasion, my father developed a broken tooth that became infected and was causing him significant pain. My mother asked that it be extracted. Instead, the request triggered a family conference involving dentists, social workers, and medical residents. Ultimately, one dentist argued that the tooth should not be pulled and suggested allowing the infection to run its course given my father's condition.

Experiences like these make families wonder whether their loved one's values are truly being respected. I thought about residents I work with and their communication with families: do they do this? Having challenging discussions while being respectful and humble with regard to the family's experience is a difficult skill to master and teach.

Families bring deeply held values -- cultural, moral and religious -- to decisions about care. Those beliefs should not automatically be dismissed as ignorance or denial. When families misunderstand the prognosis, physicians should provide clear and compassionate education. But not every disagreement reflects a lack of understanding. Sometimes it simply reflects different priorities.

These situations create genuine ethical dilemmas. Physicians must balance professional judgment with respect for patient autonomy. But when the balance tips too far toward paternalism, the consequences are profound.

Trust begins to erode. Trust is the foundation of the physician-patient relationship. Without it, even the most technically excellent care becomes difficult for families to accept.

In my father's case, the feeding tube was ultimately placed after the hospital's patient advocacy office became involved. The intern's statement that the team could simply "refuse anything" raised more than a few eyebrows. The dentist involved in the earlier dispute was also removed from my father's care team. Yet, the damage was done. My family no longer trusts the medical team caring for my father, and that trust cannot be rebuilt.

Not every interaction was negative. An anesthesia resident showed remarkable kindness and respect toward my mother as she struggled with one of the most difficult decisions of her life. That moment served as a reminder of what medicine can look like at its best.

DeAnna M. Pollock, MD, is an anesthesiologist and the associate program director of the Anesthesiology Residency Program at Common Spirit St. Joseph's Medical Center in Stockton, California. She writes about medical ethics and patient advocacy.

https://www.medpagetoday.com/opinion/second-opinions/120599