Clinical trials for the blood substitute PolyHeme exposed the possibility for ambiguous interpretation of the FDA’s waiver of informed consent for emergency research.
To be a useful tool for assessing quality of physician care, pay-for-performance must be designed to include process measures and to not penalize physicians for treating patients with difficult-to-manage conditions.
Physicians have an obligation to consider a patient’s quality of life when making treatment decisions and should consider giving patients the options of withholding or withdrawing aggressive treatment if that treatment will not restore the kind of life the patient finds meaningful.
The ongoing anthrax vaccination case, Doe v Rumsfeld, tests whether the military can require participation in and punish refusal of a vaccination program while waiving informed consent.
Raphael P. Viscidi, MD and Keerti V. Shah, MD, DrPH
The arguments for mandatory vaccination with human papillomavirus vaccine differs from the justification for mandatory use of vaccines that protect against more easily transmitted diseases.
Appropriate use of the pay-for-performance system may improve quality of care by counteracting physician incentives to overtreat in fee-for-service situations or undertreat in capitation plans.