This case is challenging because it represents a potential error on the part of the radiologist who interpreted a previous film—not the doctor who is currently treating the patient. While standards are being developed to help doctors disclose their own errors, guidelines for discussing other doctors’ errors with patients are lacking.
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.
The growing number of web-savvy patients alters the power dynamic in the patient-physician relationship. In the older model of care, physicians served as unchallenged experts who alone devised therapeutic plans for patients.
People have a social obligation to conform to the general rules of sleeping: sleep at night, in a bed, in a private place away from public view, and in proper attire.
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.
The authors address the medical ethics question of whether autopsy is necessary from Cartesian and sociocultural perspectives and how to obtain consent.
AMA J Ethics. 2016; 18(8):771-778. doi:
10.1001/journalofethics.2016.18.8.ecas2-1608.
The U. S. health care system encourages patients to take more responsibility for their own treatment decisions and expects their doctors to cooperate in that effort. But the guidelines for exercising that responsibility remain very murky indeed.