Skip to main content
Erschienen in: Clinical Orthopaedics and Related Research® 2/2009

01.02.2009 | Symposium: Clinical Risk and Judicial Reasoning

Beyond Informed Consent: Educating the Patient

verfasst von: Lawrence H. Brenner, JD, Alison Tytell Brenner, BA, Daniel Horowitz, MD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 2/2009

Einloggen, um Zugang zu erhalten

Abstract

The informed consent doctrine was conceived as a basis for allowing patients to meaningfully participate in the decision-making process. It has evolved into a formal, legal document that reflects a desire by physicians and surgeons to have patients execute “waivers of liability.” In the process it has lost its educational value by shifting the emphasis to obtaining a “preoperative release” from an exchange of information upon which a patient can make important decisions about their healthcare choices. This is unfortunate because, in the process, both patients and physicians have suffered. Patients have become alienated from the informed consent process and, paradoxically, physicians and surgeons may have created more liability exposure through this alienation. We propose that by returning to an educational model, the patients will develop a greater sense of control, become more compliant, and potentially experience improved healthcare outcomes. There may also develop an alliance between the patient and the physician or surgeon, such that the seeds of an antagonistic or litigious relationship will not be planted before treatment begins. Liability reduction, therefore, may more likely arise from the educational model.
Literatur
1.
Zurück zum Zitat Ali V. Consent forms as part of the informed consent process: Moving away from “medical Miranda.” Hastings Law J. 2003;54:1575–1591.PubMed Ali V. Consent forms as part of the informed consent process: Moving away from “medical Miranda.” Hastings Law J. 2003;54:1575–1591.PubMed
2.
Zurück zum Zitat Andrews LB. Informed consent statutes and the decisionmaking process. J Leg Med. 1984;5:163–217.PubMedCrossRef Andrews LB. Informed consent statutes and the decisionmaking process. J Leg Med. 1984;5:163–217.PubMedCrossRef
3.
Zurück zum Zitat Appelbaum PS, Lidz CW, Meisel A. Informed Consent: Legal Theory and Clinical Practice. New York, NY: Oxford University Press; 1987. Appelbaum PS, Lidz CW, Meisel A. Informed Consent: Legal Theory and Clinical Practice. New York, NY: Oxford University Press; 1987.
4.
Zurück zum Zitat Braddock CH 3rd, Edwards KA, Hasenberg NM, Laidley TL, Levinson W. Informed decision making in outpatient practice: time to get back to basics. JAMA. 1999;282:2313–2320.PubMedCrossRef Braddock CH 3rd, Edwards KA, Hasenberg NM, Laidley TL, Levinson W. Informed decision making in outpatient practice: time to get back to basics. JAMA. 1999;282:2313–2320.PubMedCrossRef
5.
Zurück zum Zitat Brody DS, Miller SM, Lerman CE, Smith DG, Caputo GC. Patient perception of involvement in medical care: relationship to illness attitudes and outcomes. J Gen Intern Med. 1989;4:506–511.PubMedCrossRef Brody DS, Miller SM, Lerman CE, Smith DG, Caputo GC. Patient perception of involvement in medical care: relationship to illness attitudes and outcomes. J Gen Intern Med. 1989;4:506–511.PubMedCrossRef
6.
Zurück zum Zitat Brody DS, Miller SM, Lerman CE, Smith DG, Lazaro CG, Blum MJ. The relationship between patients’ satisfaction with their physicians and perceptions about interventions they desired and received. Med Care. 1989;27:1027–1035.PubMedCrossRef Brody DS, Miller SM, Lerman CE, Smith DG, Lazaro CG, Blum MJ. The relationship between patients’ satisfaction with their physicians and perceptions about interventions they desired and received. Med Care. 1989;27:1027–1035.PubMedCrossRef
7.
Zurück zum Zitat Brownlee S. Overtreated. New York, NY: Bloomsbury; 2007. Brownlee S. Overtreated. New York, NY: Bloomsbury; 2007.
8.
Zurück zum Zitat Cobbs v. Grant 8 Cal. 2nd 229 (1972). Cobbs v. Grant 8 Cal. 2nd 229 (1972).
9.
Zurück zum Zitat Fielding S. The Practice of Uncertainty: Voices of Patients in Medical Malpractice Claims. Westport, CT: Auburn House; 1999. Fielding S. The Practice of Uncertainty: Voices of Patients in Medical Malpractice Claims. Westport, CT: Auburn House; 1999.
10.
Zurück zum Zitat Frosch DL, Kaplan RM. Shared decision making in clinical medicine: Past research and future directions. Am J Prev Med. 1999;17:285–294.PubMedCrossRef Frosch DL, Kaplan RM. Shared decision making in clinical medicine: Past research and future directions. Am J Prev Med. 1999;17:285–294.PubMedCrossRef
11.
Zurück zum Zitat Greenfield S, Kaplan S, Ware JE Jr. Expanding patient involvement in care. Effects on patient outcomes. Ann Intern Med. 1985;102:520–528.PubMed Greenfield S, Kaplan S, Ware JE Jr. Expanding patient involvement in care. Effects on patient outcomes. Ann Intern Med. 1985;102:520–528.PubMed
12.
Zurück zum Zitat Grundner TM. On the readability of surgical consent forms. N Engl J Med. 1980;302:900–902.PubMed Grundner TM. On the readability of surgical consent forms. N Engl J Med. 1980;302:900–902.PubMed
13.
Zurück zum Zitat Gutheil TG, Bursztajn H, Brodsky A. Malpractice prevention through the sharing of uncertainty. Informed consent and the therapeutic alliance. N Engl J Med. 1984;311:49–51.PubMedCrossRef Gutheil TG, Bursztajn H, Brodsky A. Malpractice prevention through the sharing of uncertainty. Informed consent and the therapeutic alliance. N Engl J Med. 1984;311:49–51.PubMedCrossRef
14.
Zurück zum Zitat Hadler NM. The Last Well Person: How to Stay Well Despite the Health-care System. Montreal, Quebec, Canada: McGill-Queen’s University Press; 2004. Hadler NM. The Last Well Person: How to Stay Well Despite the Health-care System. Montreal, Quebec, Canada: McGill-Queen’s University Press; 2004.
15.
Zurück zum Zitat Lerman CE, Brody DS, Caputo GC, Smith DG, Lazaro CG, Wolfson HG. Patients’ perceived involvement in care scale: Relationship to attitudes about illness and medical care. J Gen Intern Med. 1990;5:29–33.PubMedCrossRef Lerman CE, Brody DS, Caputo GC, Smith DG, Lazaro CG, Wolfson HG. Patients’ perceived involvement in care scale: Relationship to attitudes about illness and medical care. J Gen Intern Med. 1990;5:29–33.PubMedCrossRef
16.
Zurück zum Zitat Payer L. Medicine and Culture. 2nd ed. New York, NY: Henry Holt & Co; 1996. Payer L. Medicine and Culture. 2nd ed. New York, NY: Henry Holt & Co; 1996.
17.
Zurück zum Zitat Sudore RL, Landefeld CS, Williams BA, Barnes DE, Lindquist K, Schillinger D. Use of a modified informed consent process among vulnerable patients: A descriptive study. J Gen Intern Med. 2006;21:867–873.PubMedCrossRef Sudore RL, Landefeld CS, Williams BA, Barnes DE, Lindquist K, Schillinger D. Use of a modified informed consent process among vulnerable patients: A descriptive study. J Gen Intern Med. 2006;21:867–873.PubMedCrossRef
18.
Zurück zum Zitat Weithorn LA, Scherer DG. Children’s involvement in research participation decisions: psychological considerations. In: Grodin MA, Glantz LH, eds. Children as Research Subjects. New York, NY: Oxford University Press; 1994:133–180. Weithorn LA, Scherer DG. Children’s involvement in research participation decisions: psychological considerations. In: Grodin MA, Glantz LH, eds. Children as Research Subjects. New York, NY: Oxford University Press; 1994:133–180.
Metadaten
Titel
Beyond Informed Consent: Educating the Patient
verfasst von
Lawrence H. Brenner, JD
Alison Tytell Brenner, BA
Daniel Horowitz, MD
Publikationsdatum
01.02.2009
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 2/2009
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-008-0642-4

Weitere Artikel der Ausgabe 2/2009

Clinical Orthopaedics and Related Research® 2/2009 Zur Ausgabe

Orthopaedic • Radiology • Pathology Conference

Low Backache in a 70-year-old Woman

Symposium: Clinical Risk and Judicial Reasoning

Medical Malpractice and the Sports Medicine Clinician

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.