Critical skills required to weigh decisions with serious consequences, manipulate information rationally, and choose wisely are skills that are likely to be impaired by frontal lobe injury that results in personality change.
Using the patient’s worldview to challenge his or her decision and establish a treatment plan—implying the view is shared by the physician when it is not—could be seen as manipulative and deceptive.
Physicians make patients aware of those interventions that they (the patients) may then refuse. In short, informed consent is less about patient decisions than it is about restraining physicians.
Alexander Craig, MPhil and Elizabeth Dzeng, MD, PhD, MPH
Eliciting the patient’s motives and goals and helping the patient and her loved ones explore alternatives are essential to maintaining trusting relationships and open communication.
AMA J Ethics. 2018;20(8):E690-698. doi:
10.1001/amajethics.2018.690.
Dr Jane Lee joins Ethics Talk to discuss her article, coauthored with Drs Gabriel Robles and Latoya Small: “What Should Students Learn About the Importance of Cultural Brokering in Immigrant Communities?”
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.