Clinical inertia : An Ethical Reflection in Clinical Practice

Abstract

  Clinical inertia, the failure to initiate or intensify therapy despite unmet treatment goals (Phillips et al., 2001), is a major challenge in chronic disease management, including diabetes and hypertension. This phenomenon is increasingly understood not just as a practitioner’s inaction, but as an issue linked to cognitive attitudes like clinical myopia and clinical nihilism. This article re-examines clinical inertia through the lens of clinical ethics, analyzing its relationship with the core principles of respect for autonomy, beneficence, non-maleficence, and justice. We argue that insufficient support for patient self-determination directly contributes to clinical inertia, posing significant ethical barriers to patient-centered care. To overcome this challenge, we highlight the importance of key strategies : Clinician education, shared decision making (SDM), and enhanced support for patient adherence. By positioning clinical inertia not merely as a clinical issue but as an object of ethical analysis, this study elucidates the ethical vulnerabilities inherent in physicians’ decision-making processes.