Dr Jonathan Treem joins Ethics Talk to discuss his article, coauthored with Drs Joel Yager and Jennifer L. Gaudiani: “A Life-Affirming Palliative Care Model for Severe and Enduring Anorexia Nervosa.”
Nicholas Freudenberg, MD and Peter M. Yellowlees, MBBS, MD
Ideally, telepsychiatry treatment should include collaboration with patients’ primary care physicians. One way to facilitate the collaboration is for patients to have videoconference appointments with their psychiatrists in the primary care clinic.
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.
The eradication of hazing has not diminished the socialization, camaraderie, or commitment of new recruits. The physical, emotional, and mental demands of basic training suffice to produce the outcomes previously ascribed to hazing.
Requirements for informed consent are relatively vague and the exceptions are few, so it is in the physician’s best interest to inform patients about proposed treatment options, ascertain that they understand their choices, and secure their consent.