The AAP’s guidelines on lipid screening for children raise concerns about the fundamental purpose of prevention and its role in balancing individual autonomy with the benefits of society at large.
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.
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.
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.