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Biomedical subjects

M B Kapp

Publications and source records attributed to M B Kapp.

At least 19 recordsLinked to original sources
PubMed1991

Health care decision making by the elderly: I get by with a little help from my family.

Shared decision making about placement and medical interventions can be empowering to the older person involved, relieve burdens on the older person and family members, and facilitate better surrogate decision making later. Potential dangers of the shared process include coercion, conflicts of interest, and disagreements between family members. New legal concepts, similar to those governing property, could help our legal system better accommodate the realities of shared decision making.

Aged↗
PubMed1989

Enforcing patient preferences. Linking payment for medical care to informed consent.

The legal and ethical doctrine of informed consent is well accepted in modern medicine. Nonetheless, medical interventions sometimes take place in the absence of informed consent, particularly in the case of life-sustaining medical procedures. These procedures ordinarily are reimbursed by third-party payers. This article proposes as a strategy to ensure greater attention to patient preferences in medical decision making that financial reimbursement for each medical service be linked to a requirement of valid patient (or surrogate) consent to the service involved. Utilization review bodies could monitor informed consent in the same way that other aspects of necessity, appropriateness, and quality are now monitored.

Consent Forms↗
PubMed1989

The malpractice crisis. Relevance for geriatrics.

The adverse effects of the current American medical malpractice problem on the practice of geriatric medicine have thus far been relatively minor, but real. This article discusses some of the prominent public policy issues involved in the ongoing debate about malpractice, with special application to older patients and their physicians. Suggestions are made for appropriate actions by geriatricians individually and collectively, in response to the malpractice situation.

Age Factors↗
PubMed1989

Informed consent for federal clinicians.

The principle of informed consent to medical care is by now well recognized but incompletely understood and implemented. This article discusses the ethical and legal foundations of the informed consent doctrine, the relevance of informed consent for health care providers employed by the federal government, the elements of valid consent, the concept of state substantive law as governing, different information disclosure standards, disclosure elements, exceptions to the consent requirement, and the proper documentation of consent.

Consent Forms↗
PubMed1989

Advocacy for the mentally impaired elderly: a case study analysis.

The authors present a case study to illustrate how a mentally impaired but socially intact nursing home resident, who had no one to act as an advocate for her, was denied appropriate treatment for an acute illness which ultimately resulted in her death. The case raises important questions about advocacy for the mentally-impaired, acutely-ill institutionalized patient. This Article explores the role of the advocate, how advocates are selected, what qualities and talents they should possess, and what responsibilities should be assigned to them. The authors suggest that nursing home residents should be encouraged to engage in self-advocacy to the greatest extent possible. The competent elderly should be urged to name their preferred advocates. Individuals who serve in advocacy roles should be advised to seek information regarding the patient's wishes from those who know the patient well. Furthermore, there is a need for quality education and training of those who serve in advocacy roles on behalf of nursing home residents, and state laws need to specify the responsibilities of persons who serve as advocates.

Aged↗