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PubMed1991

Ethical issues in caring for patients who have suffered water-related injuries.

A person who has suffered a water-related injury is vulnerable and most likely in need of the most astute emergency and supportive medical and nursing care available. Caring for these persons from a medical and nursing perspective is challenging and additionally complicated by numerous ethical dilemmas. This article has reviewed the salient issues associated with informed consent, the erroneous perceptions frequently associated with ordinary and extraordinary treatment and the withholding and withdrawing of treatment, as well as the importance of the nurse as a patient advocate. The hallmark of effective ethical decision making about life-supportive treatment is the mutually interactive process of communication that assists patients and their families to make informed, voluntary, and competent decisions that are reflective of their values. This process of empowering the patient and family is the foundation of the role of the nurse as a patient's advocate. It is hoped that your interest in bioethics has been sparked, your understanding of these areas clarified, your decision-making skills strengthened, and your caring for people enhanced.

Comprehension↗
PubMed1989

Physician self referral arrangements: legitimate business or unethical "entrepreneurialism".

An emerging legal and ethical controversy in the health care industry centers on physician investment in health care facilities to which they make patient referrals. This Article analyzes the policy debate surrounding these physician self referral arrangements as well as the various responses to such arrangements. The Article asserts that an effective legal or ethical response to self referral arrangements must acknowledge and balance both the possible pro-competitive effects of such arrangements and the inherent potential for abuses in this type of business practice. From this perspective, the most effective form of regulation consists of extensive structural guidelines which focus on the physician's referral behavior and limit restrictions on investment procedures. Such an approach would minimize referral abuses and conflict of interest concerns but promote business and competitive freedom.

Disclosure↗
PubMed1996

Bioethics for clinicians: 2. Disclosure.

In the context of patient consent, "disclosure" refers to the provision of relevant information by the clinician and its comprehension by the patient. Both elements are necessary for valid consent. Disclosure should inform the patient adequately about the treatment and its expected effects, relevant alternative options and their benefits and risks, and the consequences of declining or delaying treatment. The clinician's goal is to disclose information that a reasonable person in the patient's position would need in order to make an informed decision. Therefore, clinicians may need to consider how the proposed treatment (and other options) might affect the patient's employment, finances, family life and other personal concerns. Clinicians may also need to be sensitive to cultural and religious beliefs that can affect disclosure.

Adult↗