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.
There are “push” factors such as poor working conditions, substandard facilities, unsafe conditions, and low income that discourage health professionals trained in Indian medical schools from staying in country.
The growing number of web-savvy patients alters the power dynamic in the patient-physician relationship. In the older model of care, physicians served as unchallenged experts who alone devised therapeutic plans for patients.
In an extreme response to the threat of student violence, a school district in Texas certified its teachers to carry weapons and sanctioned them to respond to threats with deadly force if necessary.
As the United States became more successful in preventing and treating many infectious diseases, homicide and suicide rose in the rankings of causes of death.
The greatest pressure to resuscitate the extremely low-birth-weight infant often results from successful marketing efforts that lead families to expect that their premature infants will be cute and healthy.
People have a social obligation to conform to the general rules of sleeping: sleep at night, in a bed, in a private place away from public view, and in proper attire.
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.
Physicians new to a case might object to an established care plan. Practice variation, clinical momentum, and how value is assigned by different parties to acute care and comfort measures can each contribute to conflict in these cases.
AMA J Ethics. 2018;20(8):E699-707. doi:
10.1001/amajethics.2018.699.