Treatment decisions in high-risk situations require a dynamic relationship between doctor and patient in which patient preferences and clinician recommendations contribute equally in shaping a final treatment decision.
A medical student has no duty to refrain from repeating a clinical instructor’s comments except for patient-revealing elements. He may, in fact, have a duty to repeat those remarks to someone who can correct the instructor.
Is it ethical for a psychiatrist to monitor a patient’s blog without the patient’s permission? If so, what information from the blog is suitable for entry in the patient’s medical record?
The physician must help patients understand that all options—further testing, surgery, no action—carry risks and benefits. Disclosing the statistical probability of injury and other possible outcomes might help, but it can also hinder the process.
After assessing the reasons for a patient’s unrealistic hopefulness in the face of clear understanding, a clinician may believe that significant harm will come to the patient if he or she does not acknowledge the seriousness of the illness.