Argumentation and informed consent in the doctor–patient relationship

2012 ◽  
Vol 1 (1) ◽  
pp. 5-18 ◽  
Author(s):  
Jerome Bickenbach
Keyword(s):  
Health Care ◽  
Informed Consent ◽  
Patient Autonomy ◽  
Argumentation Theory ◽  
Necessary Condition ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Consent To Treatment

Argumentation theory has much to offer our understanding of the doctor-patient relationship as it plays out in the context of seeking and obtaining consent to treatment. In order to harness the power of argumentation theory in this regard, I argue, it is necessary to take into account insights from the legal and bioethical dimensions of informed consent, and in particular to account for features of the interaction that make it psychologically complex: that there is a fundamental asymmetry of authority, power and expertise between doctor and patient; that, given the potential for coercion, it is a challenge to preserve the interactive balance presumed by the requirement of informed consent; and finally that the necessary condition that patients be ‘competent to consent’ may undermine the requirement of respecting patient autonomy. I argue argumentation theory has the resources to deal with these challenges and expand our knowledge, and appreciation, of the informed consent interaction in health care.

scholarly journals POLST Signature Requirements: Responding With Compassion While Ensuring Informed Consent

2020 ◽  
pp. 104990912095308
Author(s):  
Robert Macauley ◽  
Susan Tolle
Keyword(s):  
Health Care ◽  
Informed Consent ◽  
Decision Maker ◽  
Health Care Professional ◽  
Patient Autonomy ◽  
Necessary Condition ◽  
Surrogate Decision Maker ◽  
Decisional Capacity ◽  
Spiritual Distress ◽  
Surrogate Decision

The majority of states require the signature of a surrogate decision maker on a POLST form for a patient who lacks decisional capacity. While commendable in its intention to ensure informed consent, in some cases this may lead the surrogate to feel that they are signing their loved one’s “death warrant,” adding to their emotional and spiritual distress. In this paper we argue that such a signature should be recommended rather than required, as it is neither a sufficient nor necessary condition of informed consent. Additional steps—such as requiring the attestation and documentation of the signing health care professional that verbal consent was fully informed and voluntary—can achieve the ultimate goal of respecting patient autonomy without adding to the surrogate’s burden.

scholarly journals Physician-Patient Relationship: The Present Situation and Our Responsibilities

2014 ◽  
Vol 41 (1) ◽  
pp. 55-58
Author(s):  
MS Islam ◽  
ST Jhora
Keyword(s):  
Health Care ◽  
Developed Countries ◽  
Present Moment ◽  
Patient Relationship ◽  
Professional Relationship ◽  
Physician Patient Relationship ◽  
Doctor Patient Relationship ◽  
Quality Health Care ◽  
Quality Health ◽  
Physician Patient

The "doctor-patient" relationship (DPR) or the "physician-patient" relationship (PPR) has long been recognized as a complex, multifaceted, and complicated balance of engagement between the care-seeker and the care-giver. The physician-patient relationship is central to the practice of healthcare and is essential for the delivery of high-quality health care in the diagnosis and treatment of disease. The doctor-patient relationship forms one of the foundations of contemporary medical ethics. In the present moment doctor-patient relationship (DPR) or physician-patient relationship (PPR) is one of the major issues in health-care throughout the world. The most common complains about the physicians of Bangladesh is their attitude towards the patients. The patients must have confidence in the competence of doctors and should feel that they can confide in him or her. For physicians, the establishment of a good relationship with the patients is also important. In developed countries students are taught from the beginning, even before they set foot in hospitals, to maintain a professional relationship with the patients, to uphold patients' dignity, and respect their privacy. These are deficient in Bangladesh. In addition to service factors, perceived treatment cost is another factor that patients may perceive as excessive. This special article reflects the importance as well as the necessary elements to establish this sacred relationship. DOI: http://dx.doi.org/10.3329/bmj.v41i1.18786 Bangladesh Medical Journal 2012 Vol. 41 No. 1; 55-58

Informed consent of the critically ill patient and drug therapy: legal aspects

2013 ◽  
Vol 4 (2S) ◽  
pp. 21-30
Author(s):  
Riccardo Fresa
Keyword(s):  
Informed Consent ◽  
Legal Aspects ◽  
Third Parties ◽  
Legal Issues ◽  
Self Determination ◽  
Critically Ill Patient ◽  
Patient Relationship ◽  
Life Meaning ◽  
Consent To Treatment ◽  
To Receive

Legal issues concerning the doctor-patient relationship are numerous, and belong to the wider field of professional liability in health care. This article will be dealt with the issues related to informed consent in patients temporarily unable to express consent, or patients who are in a state of temporary incapacity. If the patients are temporarily incapable, and therefore are not able to receive the information nor to express consent to treatment, the physicians’ duty to provide medical treatment and the patients’ self-determination should be considered: the patients can consent or refuse treatment only if able to understand the significance of their decision. If a patient is temporarily unable to give consent and the practitioner doesn’t have at his/her disposal a valid document reporting the patient’s wishes, it’s necessary to rely on the so called “amministratore di sostegno” (introduced in the Italian legal system by Law n. 6 of January 9th, 2004). But in the case of not deferrable treatment, as a lifesaving intervention, the rule is in dubio pro life meaning that a doctor is always legitimized by this situation of urgent need, regardless of the informed consent of the patient and/or third parties.

Reflection Over Doctor Patient Relationship: A Promise of Trust

2014 ◽  
Vol 8 (2) ◽  
pp. 104-108 ◽  
Author(s):  
S Prasad ◽  
C Dhingra ◽  
R Anand
Keyword(s):  
Health Care ◽  
Care Delivery ◽  
Social Setting ◽  
Quality Service ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Care Delivery Model ◽  
Provision Of Care ◽  
The Relationship ◽  
Unique Relationship

ABSTRACT The doctor patient relationship is of primary importance in the overall health care delivery model. It is a unique relationship which depends on trust and confidence between the parties for the provision of care. Establishing a doctor/patient relationship may take place formally in the office setting or informally, such as by giving verbal advice in a social setting. Doctors enter into a doctor-patient relationship with a commitment to provide their patients with quality service. Patients are entitled to be treated with respect and without discrimination during all stages of the doctor patient relationship, even if the relationship faces termination. However, when circumstances affect the doctors ability to achieve this, the doctors may decide to end the doctors patient relationship.

Distinctions in Disclosure: Mandated Informed Consent in Abortion and ART

2015 ◽  
Vol 43 (2) ◽  
pp. 255-258
Author(s):  
Judith Daar
Keyword(s):  
Health Care ◽  
Informed Consent ◽  
Patient Autonomy ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Assisted Conception ◽  
Patient Protection ◽  
Disclosure Laws ◽  
Transparency And Disclosure ◽  
Required Disclosures

Transparency and disclosure in the health care realm occupy a vital link between the delivery of medical services and patient autonomy. In her article, “Disclosure Two Ways,” Erin Bernstein skillfully explores this link in the context of abortion and assisted conception services, keenly observing the rise in mandatory disclosure laws in both arenas. Her thesis, as I understand it, is that laws that require enhanced disclosure above traditional informed consent thresholds can be understood as neutral tools in the name of patient protection, even — or perhaps especially — when their effect is to persuade a patient to forego the requested treatment. She combats the critique that pre-abortion required disclosures are sui generis, arguing against their uniqueness by analyzing them alongside a swell of mandated disclosure laws in the assisted reproductive technologies (ART) context.

scholarly journals Kommunikáció az egészségügyben – jogi vonatkozások

2016 ◽  
Vol 157 (17) ◽  
pp. 675-679
Author(s):  
András Mina
Keyword(s):  
Health Care ◽  
Adverse Events ◽  
Legal Aspects ◽  
Patient Relationship ◽  
Information Communication ◽  
Doctor Patient Relationship

This paper is focusing on the legal aspects of communication in health care, especially on doctor–patient relationship, responsibility for information, communication of adverse events, and legal declarations. Orv. Hetil., 2016, 157(17), 675–679.

Beyond Medicine: Healing Power in the Doctor-Patient Relationship

1985 ◽  
Vol 57 (2) ◽  
pp. 399-427 ◽  
Author(s):  
Lucille Hollander Blum
Keyword(s):  
Health Care ◽  
Physical Health ◽  
Physical Symptoms ◽  
Health Improvement ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Equal Importance ◽  
Healing Power ◽  
Physical Health Care ◽  
The Relationship

Healing power in the doctor-patient relationship is addressed to physicians in physical health care and to medical students but is of equal importance to dentists, social workers, nurses, and teachers in the field of physical health care. The presentation points up that in the relationship between physician and patient certain phenomena occur that are comparable to responses in the relationship between the psychoanalyst and analysand, such as transference and countertransference. This indicates that the physician in physical health care in effect is involved in some kind of psychotherapy. Aspects of the art of medicine are described. Emphasis is on the potential for patients' physical health improvement—placebo effect—when the providers' perception extends beyond focus on physical symptoms and disorders and includes attention to the patients' psychological and emotional needs.

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