Withholding information from patients during an informed consent process is ethically unacceptable. Patients may restrict the amount of information they wish to receive or designate someone else to receive the information for them.
AMA J Ethics. 2015;17(3):209-214. doi:
10.1001/journalofethics.2015.17.3.ecas2-1503.
This month, AMA Journal of Ethics editor-in-chief Audiey Kao, MD, PhD, interviewed Wendy Levinson, MD, about the efforts of the Choosing Wisely initiative to foster cultural change in medicine cross-nationally by stimulating dialogue about overuse of tests and treatments
Nonmaleficence must not be sacrificed in the name of the patient’s autonomy, but there is no need to undertake needlessly invasive treatments for a small boost in protection against cancer recurrence if the patient does not wish to do so.
Although not everything on the Choosing Wisely lists is likely to reduce low-value care, it is a good starting point for a conversation about curtailing low-value interventions.
David S. Gierada, MD and Lawrence M. Kotner, Jr., MD
Despite strong supportive evidence on and professional society endorsement of CT screening for lung cancer, there is minimal demand from patients or physicians.
Believing that unnecessary use of resources is a significant contributor to rising health care costs, the ABIM Foundation launched the Choosing Wisely campaign, in which physicians and patients work together to develop treatment plans that are effective for the patient but are also efficient and promote the sustainable use of limited resources.
Comparative effectiveness research (CER) may become an important factor in Medicare coverage decisions, and the new health care law may make it more easily available to the public to help in medical decision making.
The purpose of assessing dangerousness is to determine whether an individual poses a risk of endangering self or others now or in the near future and to identify what interventions are necessary to minimize that risk.