“Difficult” patient-physician encounters have roots in uncertainty about individuals’ trustworthiness, clinicians’ skills and training, and medical science.
AMA J Ethics. 2017;19(4):391-398. doi:
10.1001/journalofethics.2017.19.4.mhst1-1704.
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.
Quality improvement initiatives in clinical medicine are part research and part patient care and pose challenges to traditional forms of ethical oversight.