Using the patient’s worldview to challenge his or her decision and establish a treatment plan—implying the view is shared by the physician when it is not—could be seen as manipulative and deceptive.
The hospitalist sued in Domby v. Moritz was judged to have met the applicable standard of care for a hospitalist—supervising a patient’s medical care while the patient was in the hospital. Dr. Moritz was not held to the consulting cardiologist’s standard.
Cytopathologists frequently interact directly with patients at their bedsides to perform fine needle aspiration procedures. When, if ever, should cytopathologists share preliminary diagnostic impressions directly with patients?
AMA J Ethics. 2016;18(8):779-785. doi:
10.1001/journalofethics.2016.18.8.ecas3-1608.
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.
Equating conscience with clinical judgment challenges the way that ethics is marginalized in medical education. Ethics is simply an account of what good medical practice looks like in particular situations.
The gross negligence of the physicians who cared for Steve Biko, an apartheid-era South African political activist who died of injuries inflicted while in police custody, illustrates how dual loyalty—toward patients and, in this case, the state—makes performance of professional duties difficult.
AMA J Ethics. 2015;17(10):966-972. doi:
10.1001/journalofethics.2015.17.10.mhst1-1510.
The ambiguity about and lack of uniformity in informed consent practices does not lend itself to the kind of shield from malpractice liability that exists in some more concrete, standardizable aspects of medical practice.
Timothy K. Mackey, MAS and Bryan A. Liang, MD, JD, PhD
Studies show that clinical practice guidelines, used by an accused physician or by patients alleging a breach of standard care, have an impact on case outcomes.