Week 4 Ethics Flashcards
Informed Constent
- Patient preferences are expressed
- Autonomy
- Mutual participation
- Good communication
- Mutual respect
- Shared decision making
Ideal scenario of informed consent
- Consults MD for a medical problem
- MD makes Dx and recommends Tx
- Discussion of + - and alt
- Patients understands info and chosses
Standard for Informed Consent
Reasonable Physician Standard (before)
Reasonable Patient Standard (now)
Info that is necessary for a reasonable person when making the decision (now) the information must be personalized
Scope of Disclosure (Informed Consent)
- Patient’s medical status
- Interventions that might help
- Professional opinion about alternatives
- Recommendation based on best clinical judgment
Non-Directive Genetic Counseling
The counselor presents all sides of an issue in a non-biased manner.
Purpose of prenatal diagnosis
- Diagnosis and prognosis for closure, symptom management
- Pursue potential interventions
- Planning for child with special needs
- Lifestyle changes
- Support groups
- Carrying or not child to term
Problems with Non-directiveness
- Incompatible with caring Dt-Pt relationship
- Violate ethical guidelines of beneficence
- Doctors have some obligation to be directive
Resolved by Shared Decision Making?
Exceptions to informed consent
Lack of decision-making capacity
Emergencies
Therapeutic Privilege
Waiver
Promote Shared Decision Making
Encourage the patient to play an active role
Ensure that patients are informed
Promote the patient’s best interest
Try to persuade patients
Problems with informed consent
Lack of understanding
Doctors do not provide key info
Patients do not want make decisions
Patients make decisions that contradict their best interest
