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Biomedical subjects

Steve Clarke

Publications and source records attributed to Steve Clarke.

4 recordsLinked to original sources

Public reporting of individual surgeon performance information: United Kingdom developments and Australian issues.

The United Kingdom is currently introducing public reporting of performance information for individual cardiac surgeons. The reports will indicate whether a surgeon has an acceptable level of performance, measured by in-hospital mortality. In the United States, surgeon-specific performance data have been available for over a decade. Arguments from both safety and accountability perspectives provide strong justifications for public reporting of such data. Were Australia to adopt similar public reporting processes, we should learn from overseas experiences. Surgical associations should be actively involved in developing data standards and processes for data collection, validation, analysis and publication. Any Australian policy initiative for public reporting of individual surgeon data should be backed by a political commitment to adequate funding.

Australia↗

Informed consent and surgeons' performance.

This paper argues that the provision of effective informed consent by surgical patients requires the disclosure of material information about the comparative clinical performance of available surgeons. We develop a new ethical argument for the conclusion that comparative information about surgeons' performance--surgeons' report cards--should be provided to patients, a conclusion that has already been supported by legal and economic arguments. We consider some recent institutional and legal developments in this area, and we respond to some common objections to the use of report cards on the clinical performance of surgeons.

Benchmarking↗

Informed consent without bureaucracy.

A comparison is drawn between informed consent in medicine and consenting practices in other areas of human activity, and an underlying conceptual unity is detected in all of these consenting practices. We insist on obtaining consent, in medicine and elsewhere, because of the value we place on personal autonomy. The conceptual unity of informed consent and consenting practices outside of medicine is defended against a series of objections. On the basis of the comparison with consenting practices in other areas of human activity, it is argued that bureaucratic informed consent processes in medicine are both unnecessary and unwarranted.

Disclosure↗