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.
In clinical settings, chaplains are key communicators who help mediate between patients, families, and the medical team. This month on Ethics Talk, we explore how chaplains help patients and families articulate their goals and navigate logistical and emotional challenges that arise in the hospital.
Katherine Gentry, MD, MA and Aaron Wightman, MD, MA
A patient’s refusal of tracheostomy during an anticipated difficult intubation prompts critical questions about how to best express respect for a pediatric patient’s autonomy and whether and when deviation from standard of care is clinically and ethically appropriate.
AMA J Ethics. 2018; 20(8):E683-689. doi:
10.1001/amajethics.2018.683.
As billable procedures, advance care planning (ACP) conversations need measurable outcomes and training support. Integrating ACP into standard practice is key to ensuring clinicians deliver care that matters to patients.
AMA J Ethics. 2018; 20(8):E750-756. doi:
10.1001/amajethics.2018.750.
Alexander Craig, MPhil and Elizabeth Dzeng, MD, PhD, MPH
Eliciting the patient’s motives and goals and helping the patient and her loved ones explore alternatives are essential to maintaining trusting relationships and open communication.
AMA J Ethics. 2018; 20(8):E690-698. doi:
10.1001/amajethics.2018.690.