Writing a case study of a psychiatric patient may change the patient-physician dynamic even if the patient consents to be written about. And when the patient is a minor and consent must involve her parents, the process becomes even more complicated.
New brain imaging suggests that asking patients to put themselves in their surrogates’ shoes when thinking about advance directives might lead to directives that better line up with what surrogates think they should decide.
Asymmetry in knowledge and power between (1) physicians and patients and (2) physician educators and their students creates a climate for possible abuse in both sets of relationships.