Dr Morgan C. Shields joins Ethics Talk to discuss her article, coauthored with Zohra Kantawala and Dr Ramesh Raghavan: “Why Patient-Centered Built Environment Standards Matter More Than Numbers of Beds in Inpatient Psychiatry”
Research in the PED and PICU is essential to medical understanding of the efficacy of emergency interventions. Researchers must minimize the additional stress that consent and participation in research entail for pediatric patients and their families.
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.
One strategy is to determine “triggers” that alert the primary clinician that the patient has a high symptom burden or difficulty coping with the diagnosis, prognosis, or treatment plans and should be offered palliative care services.