Fidelity
It is a principle that pertains keeping promises, especially by the physician or nurses, made by a patient. It requires telling the truth, being loyal, and advocating for the patients (Ethics Resource Center, 2009). It encourages the commitment of health care providers to the consent of the patient using their highest level of knowledge and skills, for example, commitment to provide end of life care for patients with acute illness, i.e., palliative care with no medication (Fowler & Hammer, 2013).
Beneficence and non-maleficence
Beneficence is a principle of well-doing and advocating for patients while non-maleficence is for avoiding harm or injury to patients. (Phang, 2014; Baeuchamp & Childress, 2009). Both are indirect
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In the US, the initial system concentrated on physician knowledge about an intervention and not the patient requirement, i.e., the physician was to decide the best practice as well as information to disclose to a patient. However, there was a recognizable trend towards the informed consent (Culhane et al., 2012). A case between Salgo and Leland Stanfors Jr. University Board of Trustees clearly provided a clear indication of the court resistance and struggle to adopt the autonomous approach rather than the physician paternalism (Culhane et al., 2012). The jury argued that the patient has the right to information of any risk associated with a practice. However, they argued for the physician in the sense that he/she is placed in a position to make choices that protect the patient.
In the UK, like in the US, there is a growing shift from the traditional approach of the Bolam test to a patient-centered approach (Culhane et al., 2012, p. 567). In the Bolam case, the argument is that a physician is legally correct is acting according to the standard accepted in medicine. The court ruling was that the doctor was not liable for practice violations if the practice did not require disclosure of the risks of its application (Culhane et al., 2012, p. 568).
Another similarity is the initial reliance on some degree of “professional standard of disclosure in their informed consent doctrine (Culhane et al., 2012, p. 579). As noted in above the
Katz states, “the conviction that physicians should decide what is best for their patients, and, therefore, that the authority and power to do so should remain bested in them, continued to have deep hold on the practices of the medical profession “(214).
Although the authors agree with Katz on his view of sense one and sense two, they reason that his model of shared decision making is nothing like informed consent. Shared decision making is when the doctor and the patient reach a conclusion that satisfies them both, but the authors do not agree with this notion because it violates the idea of informed consent by involving the doctor’s opinion. In sense one, the second condition states there should be no manipulation or coercion in true informed consent, and shared decision making does not recognize
Informed consent is the basis for all legal and moral aspects of a patient’s autonomy. Implied consent is when you and your physician interact in which the consent is assumed, such as in a physical exam by your doctor. Written consent is a more extensive form in which it mostly applies when there is testing or experiments involved over a period of time. The long process is making sure the patient properly understands the risk and benefits that could possible happen during and after the treatment. As a physician, he must respect the patient’s autonomy. For a patient to be an autonomous agent, he must have legitimate moral values. The patient has all the rights to his medical health and conditions that arise. When considering informed
Another issue with the implementation of Informed consent arises when the patient waives the right to Informed consent and leaves the right to make the decision on the physician. Though legally correct, this can cause psychological stress for the physician especially when the decision is about a life threatening medical condition. Moreover, this also makes the patient vulnerable to abuse. (Manthous, DeGirolamo, 2003)
De Bord, J. (2014). ETHICS IN MEDICINE University of Washington School of Medicine. Retrieved from https://depts.washington.edu/bioethx/topics/consent.html
Every patient has a right to decide on their own course of treatment and freely consent to that treatment. In order to make an educated decision they must be provided with the proper information to make an informed choice (Opinion 8.08 - Informed Consent, 2006). It is the physician’s legal and ethical obligation to provide this information when making their recommendation on treatment. The choices given must be in accordance with good medical practice (Opinion 8.08 - Informed Consent, 2006). The informed consent is the legal policy, either written or verbal, that gives full disclosure of all the information including potential risks that is applicable to the patient’s condition and treatment being offered (Kazmier, 2008).
A physician who does not provide this to his/her patient may be liable for battery or negligence in the light of the doctrine of informed consent (Thorton 2000). As patients are entitled to this information, physicians possess a duty to disclose regarding risks and hazards, while performing the procedure or treatment as agreed with the patient. If the doctrine of informed consent did not exist, physicians would be able to perform medical treatments, procedures, without a patient’s consent or full knowledge of the perils of healthcare. In addition, healthcare demands trust which is necessary between patients and physicians in order to deliver beneficial health outcomes. If the doctrine of informed consent is not performed between the patient and physician, then trust diminishes resulting in poor health outcomes (Roach 2014). An example of deliberate harm due to uninformed consent exist in the research conducted in the Tuskegee experiment, where treatment was withheld and subjects were not informed of their illness or available treatments (CDC 2013) resulting in poor health and
Informed consent is when a physician describes the treatment or procedures and the patient or the patient’s representative approves them. Implied consent is when a patient’s actions suggest obedience, such as when a patient pulls up his or her sleeve to receive a shot. Implied consent in submissive where as informed consent is more active when a patient is able to be more functional. In emergency situations however, consent by accident victims in
Informed consent is commonly obtained from patients for medical treatment procedures and protocols. While it may serves as a litigated protection and assurance for healthcare professions to confidently perform their duties as healthcare providers, informed consent also ensures patient’s understanding and acknowledgement of their involvement in multiple medical interventions pertaining to their health. As the patient sign these consent documents, they might be unaware of the existence of uncertainty in medical practice. Medicine is the evident of probability because we are not physiologically created equal. Therefore, medical uncertainty is inevitable and physicians have to face tough choices to make a decision they believe to be in patient’s
The case of Daniels v. Durham (2005), ruled that “any duty to inform [plaintiff] of the risks of the procedures would have been on the privately retained physician,
How does a doctor confirm or measure that his patient has sufficient information and enough education to satisfy the legal standards of informed consent? It would seem that this would be nearly impossible or extremely difficult at best, given that most patients have a very limited knowledge and understanding of medicine. The challenge for the doctor is to find the middle ground between providing not enough information and too much information. I will discuss the Canterbury v. Spence case (the most influential and prominent court
There was no mention of precedent or legislation during the examination of either doctor. This is probably due to the fact that each examination purely focussed
These frameworks view ethics as a way each person seeks his or her good. The Australian charter of Health Care Rights clearly states that everyone can receive services from health care. As mentioned earlier, consent gives the patient a certain degree of freedom. The UDHR preamble clearly points out that all members of the human family have the right to freedom therefore this argument clearly states that patients have the freedom to consent or not. The ethical person engages in what may be described as either deliberative reason or rational reason this means that the patient will decide to do what is good depending on his reasoning, because he will achieve goodness. This argument is clearly supported by Article 19 of the UDHR that states, “Everyone has the right to freedom of opinion and expression; this right includes freedom to hold opinions without interference and to seek, receive and impart information and ideas through any media and regardless of frontiers.” Furthermore, in medical research, potential subjects have the freedom to refuse being involved in the experiments. This means that even when the involved subjects are given enough information about the procedure and consent to participate, they are free to withdraw consent as stated by the Helsinki Declaration (2008). Therefore in order for the health professionals to gain consent, they must disclose all facts underlying the medical intervention to enable them understand, deliberate, reason and decide
What effect, if any, does the use of therapeutic privilege for deviate from fully informed consent have on medical professionals and their patients?
Whyte’s behavior was seen as careless as he would tell clients that results could be found on the internet instead of providing them with a copy (Kennedy, 2012). Mr. Whyte also waited for an “appropriate time” to tell his clients their results rather than informing them immediately, the Tribunal ruled that Whyte’s practice was inconsistent with the requirement to obtain informed consent (Kennedy, 2012). It is a crucial part of practice that before any procedure or treatment is performed, a medical professional is required to inform their patient of the exact method for the procedure in order for them to fully understand and be able to give consent. Patient consent may be implied or conversed for a minor treatment and a signature may be required for the larger operations to ensure the patient has full understanding of the procedure about to commence (Dobb,