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PubMedDate not supplied

The radiologist and informed consent: a review, comments and proposals.

In summary, the physician's duty to inform has been described and discussed. The minority and majority rule have also been defined and analyzed along with the major causes of physician failure and resistance to disclose risks. In a proper physician-patient relationship, informed consent controversy should be rare. A calm, clear, direct and properly documented disclosure of risks of a procedure is the best defense in any jurisdiction.

Disclosure↗
PubMed1993

Whistle blowing: the ethics of revealing professional incompetence within dentistry.

Traditionally, the dental profession has endorsed the view that one member should not make public--to patients or colleagues--criticisms of the work of another. Recently, the General Medical Council has disagreed, stating that there may well be circumstances when doctors should not protect colleagues from the consequences of their own mistakes. In this paper we endorse this view. We argue that 'whistle blowing' is appropriate in dentistry as well when its aim is to protect patients from the serious harm to which ignoring such errors might lead.

Clinical Competence↗
PubMed1989

The myth of informed consent: in daily practice and in clinical trials.

Until about thirty years ago, the extent of disclosure about and consent-seeking for medical interventions was influenced by a beneficence model of professional behaviour. Informed consent shifted attention to a duty to respect the autonomy of patients. The new requirement arrived on the American scene in two separate contexts: for daily practice in 1957, and for clinical study in 1966. A confusing double standard has been established. 'Daily consent' is reviewed, if at all, only in retrospect. Doctors are merely exhorted to obtain informed consent; they often minimise uncertainties about 'best' treatment and they feel duty-bound to provide patients with an unequivocal recommendation for action. 'Study consent' in a clinical trial is reviewed prospectively, and doctors are compelled by regulation to point out that there is insufficient evidence to make a rational choice between two compared treatments. It has been impossible to devise informed consent practices that satisfy, in full, the competing moral imperatives of respect for autonomy, concern for beneficence with emphasis on the value of health, and a vigil for justice. A way must be found to experiment with various discretionary approaches that would strike a realistic balance among competing interests.

Beneficence↗
PubMed1981

Disclosure standards and informed consent.

There is currently substantial disagreement about the kind of information that must be disclosed in obtaining an informed consent. This study examined physicians' interpretations of the demands of two alternative legal standards for disclosure, as well as a third standard intended to capture their normative sense of what should be disclosed to patients. Other factors which might affect disclosure practices of physicians were also studied. The findings raise questions about the extent to which a legal standard for disclosure can have an impact on medical practice; the data suggest that doctors currently disclose what they think patients want to be told. However, it appears that physicians substantially underestimate the amount of information patients wish to receive.

Disclosure↗
PubMed1992

The disclosure of celebrity HIV infection: its effects on public attitudes.

OBJECTIVES: Despite the magnitude of the acquired immunodeficiency syndrome (AIDS) epidemic, studies have shown low levels of public concern about human immunodeficiency virus (HIV)/AIDS. We investigated the effects of celebrity disclosure of HIV infection on the AIDS-related perceptions of urban men. METHODS: Measures of AIDS-related perceptions were collected from 361 men waiting for mass transportation in downtown Chicago; 252 were assessed at three time points prior to and 109 were assessed at two time points after professional basketball star Earvin "Magic" Johnson's disclosure of his HIV infection. RESULTS: Significant increases in concern about AIDS, interest in AIDS information, and talking with friends about AIDS occurred after celebrity disclosure of HIV infection. CONCLUSIONS: Celebrity disclosure of HIV seropositivity demonstrated a marked change in AIDS-related perceptions among the men surveyed. Changes in awareness due to celebrity disclosure may lead to increased readiness to reduce risk and could be viewed as a window of opportunity for HIV prevention efforts.

Adult↗
PubMed1992

Risky business: setting public health policy for HIV-infected health care professionals.

An analysis of the restrictive proposals provoked by the case of Kimberly Bergalis and four other patients apparently infected with HIV during the course of dental treatment reveals that they resulted from an inability to evaluate appropriately the infinitesimal risk of HIV transmission from practitioner to patient. The proposals also resulted from an effort to create risk prevention policy without appreciating the distinction between regulating things or procedures, which have no human rights, and regulating people, who have rights that should not be infringed without serious justification. This analysis demonstrates that the proposed restrictive policies are not justified because they do nothing to prevent the spread of HIV, and they cause unnecessary and substantial harm to health care practitioners.

American Medical Association↗
PubMed1990

'Duty to warn' vs. 'patient confidentiality': the ethical dilemmas in caring for HIV-infected clients.

An ethical dilemma that health professionals working with HIV-infected clients currently face is the issue of maintaining patient confidentiality vs. the professional's duty to warn persons at potential risk for acquiring the virus. Multiple factors are involved when trying to resolve what a health professional's obligations are when he or she becomes aware of a risk to another individual. Professional standards require that patient confidentiality be maintained in order to promote a helping relationship. Yet, the well-being of the one at risk must be considered. Legal precedents with other sexually transmitted diseases have been established that place the burden upon the clinician to warn in order to prevent litigation. Yet, an action on the part of the clinician should not be carried out just to prevent litigation. Actions that are taken should consider what is healthiest for all parties involved. Two cases are presented that cite specific instances in which a sexual partner was put at risk. A flow chart is presented that should assist in decision-making.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Ethical considerations in fitness and risk evaluations.

Physicians and other health care workers involved in the delivery of occupational health care can be confronted with difficult questions about fairness, justice and professional ethics. These issues and other ethical considerations are discussed.

Back Injuries↗