This month, AMA Journal of Ethics theme editor Trisha Paul, a second-year medical student at the University of Michigan Medical School, interviewed Kelly Parent about what makes patient- and family-centered care an inclusive approach to health care delivery and how this approach is being implemented.
When the patient delivers a low-birth-weight infant that requires extensive time in the neonatal intensive, should she be held responsible? Where do we draw the line? More importantly, on what basis do we draw the line?
After the infant’s birth, the neonatologist’s first duty is to his or her patient—the newly born infant. If clinical circumstances are different than anticipated, the physician must first consider the best interests of the baby.
False clinical and ethical dilemmas may be created when physicians ignore patient characteristics and contexts that are integral to shared decision making.
AMA J Ethics. 2017;19(2):141-146. doi:
10.1001/journalofethics.2017.19.2.ecas1-1702.
Having implied that a particular clinical decision had been made to “free up a hospital bed,” the attending physician walked away without further comments to the residents or talking with the patient.
Approximately two-thirds of men aged 50 and older diagnosed REM sleep behavior disorder develop neurologic disease, for which there is no prevention or treatment at present.
The patient appears to have decision-making capacity, has head trauma, a headache despite intoxication, and is irritable—and she refuses a CT scan of the head.
Consent sounds like a laborious process that requires much time. Actually discussing a procedure or exam with a patient doesn’t take much more time than it took to read this paragraph.
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.