January 16th, 2011 by DavedeBronkart in Health Policy, Opinion
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From the Medscape Medical Ethics article entitled “‘Some Worms Are Best Left In The Can’: Should You Hide Medical Errors?“:
Consequences aside, from a strictly ethical perspective, if a patient doesn’t realize that his physician made a mistake, should the physician fess up?
Before you jump to conclusions (as I did), look at the article’s three parts. It’s about a survey. The title is on the inflammatory side; the article is a window into physicians’ views. The introduction continues:
Evidence of the complex prisms through which physicians view these issues was apparent in the replies to four questions asked in Medscape’s exclusive ethics survey. More than 10,000 physicians responded to the survey in 2010.
Subheads:
— Mistakes that don’t harm patients. “Are there times when it’s acceptable to cover up or avoid revealing a mistake if that mistake would not cause harm to the patient?” Sixty percent said “no;” the others split between “yes” and “it depends.”
- I personally can understand this note from a survey respondent: “If there is a mistake that would have no medical effect but would cause extreme, uncalled-for anxiety, then yes,” especially since I know people (some elders, some young) who would indeed freak out, out of proportion. But, that’s a big judgment call.
- I have a harder time accepting this comment: “Why shake the patient’s trust in the doctor for something that is irrelevant?” Irrelevant is a big judgment call, and I’d be really concerned about the natural human tendency to minimize the probable impact of a mistake — especially if a provider thinks it’s all about maintaining a patient’s trust, even when the topic is their own error.
— Mistakes that might harm patients. Ninety five percent said “no;” some still said “yes!” One commented: “If the mistake has not progressed to harmfulness, then it’s essentially a non-issue. Treatment correction takes place and you move on.” Another says if there hasn’t been harm yet, “I think a ‘wait and see’ approach is okay.” Read more »
*This blog post was originally published at e-Patients.net*
January 14th, 2011 by Elaine Schattner, M.D. in Opinion
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An online friend, colleague, and outspoken patient advocate, Trisha Torrey, has an ongoing e-vote about whether people prefer to be called a “patient,” a “consumer,” a “customer,” or some other noun to describe a person who receives healthcare.
My vote is: PATIENT. Here’s why:
Providing medical care is or should be unlike other commercial transactions. The doctor, or other person who gives medical treatment, has a special professional and moral obligation to help the person who’s receiving his or her treatment. This responsibility — to heal, honestly and to the best of one’s ability — overrides any other commitments, or conflicts, between the two. The term “patient” constantly reminds the doctor of the specialness of the relationship. If a person with illness or medical need became a consumer like any other, the relationship — and the doctor’s obligation — would be lessened.
Some might argue that the term “patient” somehow demeans the healthcare receiver. But I don’t agree: From the practicing physician’s perspective, it’s a privilege to have someone trust you with their health, especially if they’re seriously ill. In this context, the term “patient” can reflect a physician’s respect for the person’s integrity, humanity and needs.
*This blog post was originally published at Medical Lessons*
December 20th, 2010 by Michael Kirsch, M.D. in Opinion, Research
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I have always felt that issues should be judged by the context of their times. For some issues, however, context provides no justification. Thankfully, the field of medical ethics has evolved into a robust discipline, and there is an enormous need for it. I have read defenses of prior ethical lapses, and even some recent ones, suggesting that context matters.
If a three-month, placebo-controlled study is conducted in the developing world testing a medicine that was highly effective against a serious illness, are the ethical dimensions considered and respected? Were the pharma companies choosing this study locale as a cheap test run for their drug, which will ultimately be marketed in the west? Is it ethically problematic not to provide additional medications to ill subjects after the 3 month trial ends? Can we be assured that a rigorous informed consent process was followed? Sadly, outrageous practices have been reported in the very recent past.
Our president and secretary of state recently and rightfully apologized to Guatemala for American experiments performed there in the 1940s when patients were intentionally infected with syphilis. These patients were mentally ill. While I can concoct a distorted and tortured rationale that would justify this reprehensible practice, such reasoning passes no threshold of decency. Some behaviors and practices are always wrong, in any context. Read more »
*This blog post was originally published at MD Whistleblower*
November 27th, 2010 by DavidHarlow in Better Health Network, Health Policy, Health Tips, Medblogger Shout Outs, News
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As patients, as family members, as friends, as health care providers, we have all faced end-of-life issues at one time or another, and we will face them again. And again.
This weekend the “Engage With Grace” message is being broadcast virally, through a “blog rally,” at a time when many people are with family and friends over the long weekend. The point is: We all need to have the potentially uncomfortable conversation with people close to us about what kind of treatment we would want, and they would want, if incapable of making or communicating healthcare decisions. CNN ran a story on “Engage With Grace” yesterday.
End-of-life decision-making has long been an issue of great personal and professional interest to me, and I am proud to have played a role in having out-of-hospital DNR orders recognized in Massachusetts by EMS providers, as an example. Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
November 22nd, 2010 by Bryan Vartabedian, M.D. in Better Health Network, Health Policy, News
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A new policy on professionalism in the use of social media was [recently] adopted by the American Medical Association (AMA). The AMA Office of Media Relations was kind enough to share a copy of the policy:
The Internet has created the ability for medical students and physicians to communicate and share information quickly and to reach millions of people easily. Participating in social networking and other similar Internet opportunities can support physicians’ personal expression, enable individual physicians to have a professional presence online, foster collegiality and camaraderie within the profession, provide opportunity to widely disseminate public health messages and other health communication. Social networks, blogs, and other forms of communication online also create new challenges to the patient-physician relationship. Physicians should weigh a number of considerations when maintaining a presence online:
(a) Physicians should be cognizant of standards of patient privacy and confidentiality that must be maintained in all environments, including online, and must refrain from posting identifiable patient information online.
(b) When using the Internet for social networking, physicians should use privacy settings to safeguard personal information and content to the extent possible, but should realize that privacy settings are not absolute and that once on the Internet, content is likely there permanently. Thus, physicians should routinely monitor their own Internet presence to ensure that the personal and professional information on their own sites and, to the extent possible, content posted about them by others, is accurate and appropriate. Read more »
*This blog post was originally published at 33 Charts*
