Medical Ethics Advisor – August 1, 2010
August 1, 2010
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Paternalism: Does it still have a place in modern medical practice?
"The paternalistic model assumes that there are shared objective criteria for determining what is best. Hence the physician can discern what is in the patient's best interest with limited patient participation . . . the physician acts as the patient's guardian, articulating and implementing what is best for the patient...The conception of patient autonomy is patient assent, either at the time or later, to the physician's determinations of what is best.""Four Models of the Physician-Patient Relationship." JAMA. April 22/29, 1992 Vol 267, No. 16. -
Physician-patient collaboration strategies
While there are uncomplicated patient cases where physician-patient communication is fairly straightforward, such communication also can range to the other end of the continuum involving end-of-life care and related decision-making. -
When the patient wants to go home to die
It's not unusual for a patient to express a desire to go home when facing the end of life, say two experts interviewed by Medical Ethics Advisor. But the decision-making to allow this can be fraught with complexity, depending on the patient's medical condition and needs. -
Banja: Shortcuts and normalization of deviance
While not every physician or nurse makes a decision to deviate from standard medical practice or rules and regulations governing that practice, it certainly does happen, according to John D. Banja, PhD, professor, department of rehabilitation medicine and medical ethicist, Center for Ethics at Emory University School of Medicine in Atlanta. -
USCCB: "Deficiencies" in conscience protections
The United States Conference of Catholic Bishops (USCCB) Secretariat of Pro-Life Activities, Richard Doerflinger, suggests that following the passage of health care reform, "there's still a number of deficiencies in conscience protection." -
Internet research raises institutional review boards
Internet research has been an issue for institutional review boards since its roots in the 1990s, and the challenges ethics boards face in reviewing such studies are in pioneer territory. -
Behavioral health groups applaud Joint Commission
Four founding partners in a public-private collaboration to advance performance measurement in behavioral health on July 21 applauded The Joint Commission's (TJC) announcement of the next phase of the "Hospital-Based Inpatient Psychiatric Hospitals" (HBIPS) core measures initiative.