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"The paternalistic model assumes that there are shared objective criteria for determining what is best. Hence the physician can discern what is in the patient's best interest with limited patient participation . . . the physician acts as the patient's guardian, articulating and implementing what is best for the patient...The conception of patient autonomy is patient assent, either at the time or later, to the physician's determinations of what is best.""Four Models of the Physician-Patient Relationship." JAMA. April 22/29, 1992 Vol 267, No. 16.
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Four founding partners in a public-private collaboration to advance performance measurement in behavioral health on July 21 applauded The Joint Commission's (TJC) announcement of the next phase of the "Hospital-Based Inpatient Psychiatric Hospitals" (HBIPS) core measures initiative.
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The United States Conference of Catholic Bishops (USCCB) Secretariat of Pro-Life Activities, Richard Doerflinger, suggests that following the passage of health care reform, "there's still a number of deficiencies in conscience protection."
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While not every physician or nurse makes a decision to deviate from standard medical practice or rules and regulations governing that practice, it certainly does happen, according to John D. Banja, PhD, professor, department of rehabilitation medicine and medical ethicist, Center for Ethics at Emory University School of Medicine in Atlanta.
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It's not unusual for a patient to express a desire to go home when facing the end of life, say two experts interviewed by Medical Ethics Advisor. But the decision-making to allow this can be fraught with complexity, depending on the patient's medical condition and needs.
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In a May 20 letter to Congress, the chairman of the U.S. Bishops' Committee on Pro-Life Activities called on Congress to remedy what he characterized asthe abortion and conscience flaws in the Patient Protection and Affordable Act (PPACA), according to a news release from the United States Conference of Catholic Bishops in Washington, DC.
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"I think most of us who take care of patients didn't get a very good education in excellent symptom management, so [many] people don't know how to take care of pain and dyspnea and anxiety and delirium and all these symptoms that truly, truly cause physical suffering," Mahon tells Medical Ethics Advisor.
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Sue Dill Calloway, RN, Esq., BSN, MSN, JD, a nurse attorney and medical legal consultant in Columbus, OH,has had considerable experience in dealing with informed consent. Calloway recently presented an audio conference on "Informed Consent 2010: The Latest in CMS and Joint Commission Consent Requirements" for AHC Media, publisher of Medical Ethics Advisor.
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The chair of the task force responsible for the fifth edition of Diagnostic and Statistical Manual of Mental Disorders, David J. Kupfer, MD, and Darrel A. Regier, co-authors of a recent commentary in JAMA, suggested their perspective in the commentary title: "Why All of Medicine Should Care About DMS-5."
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In light of "substantial attention in both professional and popular literature" regarding ethical oversight of quality improvement initiatives, researchers at Johns Hopkins University sought systematic data on this topic and they believe that's what they found.
