Current Legal and Ethical Controversies in American Health Care

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Presentation transcript:

Current Legal and Ethical Controversies in American Health Care Informed Consent and Shared Decision Making

Instructors Marshall B. Kapp, J.D. M.P.H. Gregory Todd, J.D., M.D. Associate Professor, College of Medicine Program Director, FSU Internal Medicine Residency Program

Why Informed Consent and Shared Decision Making? Autonomy/Self-Determination Beneficence

Elements of Informed Consent Voluntary Competent decision maker Informed

What Information Do You Want? Nature of the problem Recommended plan Prognosis, with or without intervention Reasonable alternatives (always including doing nothing) Risks of recommended plan and alternatives Patient’s responsibilities and limitations Financial considerations? Other?

Consent Forms Purpose/Effect Document that the process of communication took place Protect the health care provider Does not take the place of proper communication. Does create a presumption that proper communication took place, shifts burden to patient to prove that communication process was inadequate.

Case Discussions Mr. B, 75-year old man in generally good health Should physician recommend PSA screening? Should the patient consent?

Ms. A, 45-year old woman in good health, no family history of breast cancer Should physician recommend a screening mammography? Should the patient consent?

Ms. C is a 60-year-old, post-menopausal woman with no serious health problems and no significant family history of cardiovascular problems. Should her physician recommend hormone replacement therapy? Should Ms. C consent?

Shared Decision Making https://www.youtube.com/watch?v=XPm5iEDEI8Y&list=PL92C4D5A6B4CD339E https://www.youtube.com/watch?v=5kXso8aPVaw&list=PLB7F6CFCD9AFD5F47&index=14 https://www.youtube.com/watch?v=6pUeUIwQ6so&index=13&list=PLB7F6CFCD9AFD5F47