Title |
The Limits of Informed Consent for an Overwhelmed Patient: Clinicians’ Role in Protecting Patients and Preventing Overwhelm
|
---|---|
Published in |
The AMA Journal of Ethic, September 2016
|
DOI | 10.1001/journalofethics.2016.18.9.peer2-1609 |
Pubmed ID | |
Authors |
Johan Bester, Cristie M Cole, Eric Kodish |
Abstract |
In this paper, we examine the limits of informed consent with particular focus on ways in which various factors can overwhelm decision-making capacity. We introduce overwhelm as a phenomenon commonly experienced by patients in clinical settings and distinguish between emotional overwhelm and informational overload. We argue that in these situations, a clinician's primary duty is prevention of harm and suggest ways in which clinicians can discharge this obligation. To illustrate our argument, we consider the clinical application of genetic sequencing testing, which involves scientific and technical information that can compromise the understanding and decisional capacity of most patients. Finally, we consider and rebut objections that this could lead to paternalism. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 22 | 23% |
United States | 12 | 13% |
Canada | 11 | 12% |
France | 4 | 4% |
Ireland | 4 | 4% |
New Zealand | 1 | 1% |
Australia | 1 | 1% |
Curaçao | 1 | 1% |
Belgium | 1 | 1% |
Other | 4 | 4% |
Unknown | 33 | 35% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 68 | 72% |
Practitioners (doctors, other healthcare professionals) | 14 | 15% |
Scientists | 11 | 12% |
Science communicators (journalists, bloggers, editors) | 1 | 1% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 186 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Bachelor | 32 | 17% |
Student > Master | 22 | 12% |
Other | 15 | 8% |
Researcher | 12 | 6% |
Student > Ph. D. Student | 12 | 6% |
Other | 29 | 16% |
Unknown | 64 | 34% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 35 | 19% |
Nursing and Health Professions | 17 | 9% |
Social Sciences | 11 | 6% |
Biochemistry, Genetics and Molecular Biology | 10 | 5% |
Psychology | 10 | 5% |
Other | 38 | 20% |
Unknown | 65 | 35% |