Ackerman points out that "no longer is it permissible for a doctor to withhold information from a patient, even on the grounds that it may be harmful." Thus we have informed consent. Arguably, how can a doctor be sure that the patient is indeed informed, and that said patient is making a decision for about his or her health without having been coerced by family, or societal pressure? These are just some of the questions posed in the article "Why Doctors Should Intervene".
It is my belief that besides providing the best care for their patients possible according to AMA practices and standards, doctors must ensure that their position of "authority" is not abused. From my own experiences with family members, and as noted in class and in the article, there are certainly times when patients defer to their physicians to make decisions for them. If a patient chooses to do that and allow the doctor to direct his or her care without formal involvement is a choice that that patient made. At that point, and I believe the doctor has the patient's permission to intervene, but certainly the doctor should continue to inform the patient of his or her options and the course of care the doctor recommends.
Doctors should intervene when patients ask them to, (unless of course there is an emergency and a decision needs to be made quickly; or if the patient cannot speak for themselves for some reason other means should be found to ensure the patient's rights are not violated) it should not be automatically assumed that the doctor should intervene without the request being made by the patient.
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"no longer is it permissible for a doctor to withhold information from a patient, even on the grounds that it may be harmful." Thus we have informed consent."
ReplyDeleteJust because a situation has been explained to a patient and all pertinent information has been given by the doctor does not neccessarily mean that the patient can give "informed consent." Besides being coerced by family members as presence mentioned, the patient may feel intimidated by their doctor, the hospital setting and their illness, therefore feeling pressured to give in to the advice of the doctor. Furthermore, if a patient comes from a different culture or speaks a different primary language, even if the information is given, the patient may not have a conceptual equilvance in their own culture or an aspect could be misrepresented or mistranslaeted into their own language. What can be done in these situations to ensure informed consent? I am sincerely asking because it seems to be an overwhelming issue in medicine today.
First of all, is "informed consent" a legal concept? If it is, I would think that there are some criteria the delineates cases of informed consent from cases of non-informed consent.
ReplyDeleteSecondly, I am think the term "informed consent" is misleading--I can't really see how a patient who hasn't gone to medical school can be medically competent enough to make an "informed" medical decision.
I fully agree with Ackerman that "no longer is it permissible for a doctor to withhold information from a patient, even on the grounds that it may be harmful." I know we discussed in class that perhaps giving the patient all the information possible could lead into deteriorating their health, ie. depression, etc...But withholding information so as to not harm the patient in other ways to me seems unfair. I think every person is different, and how would the physician really and truly know what the reaction of the patient will be when it comes to bad news about their health?
ReplyDeleteTo be honest, I am struggling with "informed consent". I would like someone to expand on that for me so that I have a better understanding of what it is.
I must agree that it is very difficult to take a solid stand on this issue. I do believe that a doctor knows best and should provide that type of health care; however I also feel that we must be able to make our own decisions regarding the services provided.
ReplyDeleteWith regards to the commentaries, it is indeed true that you are not able to accurately assess whether or not a decision made by the patient was one that was made according to their true desires. As mentioned in the commentary by Ackerman, there are four different constraints that impede autonomous behavior:
1. Physical
2. Cognitive
3. Psychological
4. Social
All of these constraints, except for physical, seem as though they subconsciously affect the decision-making ability of the patient. If we are to believe these constraints, then doesn't it seem logical for physicians to do what they think is in the best interest of the patient? I do not believe that the sole job of our physicians is to simply act as a mechanic on our bodies. They took an oath to provide the care that they feel is in the best interest of our health.