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At least 451 records · Page 25Linked to original sources
PubMed1981

The worker's right-to-know: obstacles, ambiguities and loopholes.

Telling the worker about exposure to occupational hazards and their potentially adverse health effects has been established as an ethical principle of occupational health and safety. Situations or issues that may result in incomplete application or nonapplication of this principle include: (1) the employee's need to initiate the disclosure process; (2) medical reluctance to disclose exposure data; (3) long latency periods between exposure and effect; (4) problems of quality control; (5) the use of monitoring methods with low predictive value; (6) statutory secrecy provisions; (7) doctor-patient communication difficulties; (8) serious social and health problems not related to work environment; (9) the nonspecific nature of most work-related morbidity; and (10) the absence of any monitoring whatsoever. Obligatory disclosure of exposure information is hypothesized to spur preventive measures, environmental and personal, for both short- and long-term hazards. Where the foregoing problems interfere with full disclosure, this norm's full preventive role may not be fulfilled. Evaluation of the effect of disclosure requirements on promoting occupational health and safety must include attention to this possibility.

Disclosure↗
PubMed1995

Disclosure of imaging findings to patients directly by radiologists: survey of patients' preferences.

OBJECTIVE: The purpose of this study was to determine if patients prefer to have radiologists tell them imaging findings immediately after the examination or if they prefer to hear the results later from their referring physician. SUBJECTS AND METHODS: A simple questionnaire was devised and distributed to 261 consecutive patients in the radiology department of a large university hospital. During a 10-day period, patients seen in several departmental sections (gastrointestinal, genitourinary, CT, sonography, mammography, chest, musculoskeletal) completed the questionnaire. Patients were asked if they wanted the radiologist to tell them if the results were normal; if the results were abnormal; if they would prefer to hear the results from their family doctor, internist, or other primary care provider; and if they felt entitled to an explanation of their test results. Results were tabulated and expressed as percentages. RESULTS: Analysis of the 261 questionnaires disclosed that 92% of patients wanted the radiologist to tell them if the results are normal. An additional 7% answered "Yes, but only if I ask." If the results are abnormal (cancer, for example), 87% wanted the radiologist to tell them. An additional 7% answered "Yes, but only if I ask." CONCLUSION: Our results show that most patients prefer to hear the results of imaging examinations from the radiologist at the time of the procedure rather than to hear them later from the referring physician, regardless of the findings.

Attitude to Health↗
PubMed1981

Some considerations bearing on the doctrine of self-fulfilling prophecy in sex chromosome aneuploidy.

The doctrine of self-fulfilling prophecy has been invoked in studies of the effects of sex chromosome aneuploidy on human development as a reason for routine concealment of the diagnosis from affected children and their families. It has been assumed that knowledge of the existence of risk for deviance from normal development automatically creates a self-defeating emotional climate. This communication attempts to delineate both advantageous and deleterious aspects of self-fulfilling prophecy in the medical management of sex chromosome aneuploidy, present at alternative approach, and reviews the experience in a prospective study of 52 families where a policy of disclosure was followed.

Aneuploidy↗
PubMed1999

Playing one's cards face up in analysis: an approach to the problem of self-disclosure.

A policy of consistent willingness on the analyst's part to make his or her own views explicitly available to the patient is discussed and illustrated by clinical vignettes. Playing one's cards face up is contrasted with contemporary conceptions of selective self-disclosure by the analyst, especially with respect to the way ground rules for the analytic treatment relationship get established. The objective of the analyst playing his or her cards face up is to create a candid dialogue, thus facilitating maximally effective collaboration between analyst and patient. Concerns about the analyst's self-disclosure foreclosing exploration of the patient's unconscious fantasies and transferences, or intruding upon the patient's autonomy, are addressed, as is the relation between self-disclosure and an individual analyst's personal style.

Female↗
PubMed2006

Ethical and practical aspects of disclosing adverse events in the emergency department.

Physicians and hospitals should be aware of the ethical duty to disclose a medical error that causes harm to a patient. Disclosure should be made to the affected patient or, when appropriate, to a family member of the patient. The manner in which the disclosure process is performed is also important. In emergency medicine, disclosure discussions are problematic because of the limited nature of the patient-physician relationship. The initial disclosure can be conducted in a way that maintains or even improves the relationship with the patient, or in a manner that damages trust. This article discusses the importance of disclosure in emergency medicine; the ethical basis for, and barriers to, disclosure; and the key elements of the disclosure process.

Emergency Medicine↗