High reliability organizations operate in complex, high-hazard domains for extended periods without serious accidents, catastrophic failures, or ecological health threats.
AMA J Ethics. 2024;26(2):E171-178. doi:
10.1001/amajethics.2024.171.
Dr Larry R. Churchill joins Ethics Talk to discuss his article, coauthored with Dr Gail E. Henderson and Professor Nancy M.P. King: “Why Climate Literacy Is Health Literacy.”
Lloyd Duplechan joins Ethics Talk to discuss his article: "How High Reliability Can Facilitate Clinical, Organizational, and Public Health Responses to Global Ecological Health Risks.”
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.
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.