The Authentic Meaning of Free Speech

2020 ◽  
Vol 45 (3) ◽  
pp. 3-4
Author(s):  
Michael Arthur Vacca ◽  
Keyword(s):  
Informed Consent ◽  
Free Speech ◽  
Medical Advice ◽  
Medical Procedure ◽  
Apparent Contradiction ◽  
Common Misconception ◽  
Comprehensive Information ◽  
Abortion Counseling ◽  
Pro Life ◽  
Crisis Pregnancy

This article examines a common misconception regarding the scope of free speech in the context of abortion counseling. Specifically, a recent critique of pro-life legislation identifies an apparent contradiction between (1) requiring doctors to show an ultrasound and play a fetal heartbeat to a mother before providing her with an abortion and (2) not requiring crisis pregnancy centers to give women information on where they can procure an abortion. Giving a patient comprehensive information about the effects of a medical procedure (i.e., the death of the fetus) is a necessary element of obtaining informed consent. A pro-life intention behind such regulation neither invalidates the scientific relevance of the information nor forces a physician to provide medical advice with which he or she disagrees. In contrast, requiring a crisis pregnancy center to provide information on abortion resources changes the organization’s message to advertise practices it morally opposes.

The Limits of Informed Consent

2001 ◽  
Author(s):  
Jessica W. Berg ◽  
Paul S. Appelbaum ◽  
Charles W. Lidz ◽  
Lisa S. Parker
Keyword(s):  
Informed Consent ◽  
Medical Treatment ◽  
Free Speech ◽  
Due Process ◽  
Patient Adherence ◽  
Disease Process ◽  
Outcomes Of Care ◽  
Good Government ◽  
Due Process Of Law ◽  
Involuntary Care

It will come as no surprise to anyone who has read this far to know that we are enthusiastic supporters of informed consent. We believe that entitlement to adequate information and the right to make choices about one’s medical treatment are fundamental ethical rights that are every bit as important in the healthcare arena as, for example, free speech and due process of law are in the wider society. Moreover, informed consent does not merely have deontological value. We have argued that, if done correctly, informed consent can often lead to better doctor-patient relationships, better patient adherence to treatment plans, and a fuller understanding of the disease process on the part of the healthcare provider. Yet it is also important to understand the limits of informed consent so we do not try to make it do what it cannot do. For example, although informed consent may help in managing treatment, by itself it does not cure illness. The claims that have been made for informed consent, however, are sometimes almost that extravagant. Informed consent has been suggested as the means to protect patients from poor care (1-3), including involuntary care (4), and as a means to improve the outcomes of care (5,6). It has been proposed as the solution to the problems of nursing homes (7) and as a device for compensating patients who are harmed by poor medical treatment (8). None of these are entirely specious ideas. Several of them, indeed, may be correct in part, but it is important for us to understand what informed consent cannot do as well as what it can. Just as free speech does not guarantee good government and due process of law does not guarantee justice, so too informed consent cannot solve all of the problems of the healthcare system. In this chapter we explore some of the limitations of informed consent. Specifically, we want to suggest four propositions. First, informed consent is a mechanism for improving communication and decision making among healthcare providers and patients.

scholarly journals Cases of Left Against Medical Advice from the Emergency Department of a Tertiary Care Hospital in Kathmandu: A Descriptive Cross-Sectional Study

2020 ◽  
Vol 58 (232) ◽  
Author(s):  
Manish Nath Pant ◽  
Saswat Kumar Jha ◽  
Sauravi Shrestha
Keyword(s):  
Emergency Department ◽  
Informed Consent ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Medical Advice ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Against Medical Advice

Introduction: Left against medical advice is a worldwide phenomenon. Patients leaving against Left against medical advice do not provide the health professionals with legal impunity. A well-informed consent should be present with surety that they are well understood by the patient before they leave. The study was undertaken to study the prevalence of patients that leave against medical advice. Methods: This is a descriptive cross-sectional study done in the emergency department of a tertiary care hospital from 1st February 2020 to 31 July 2020. Ethical approval was taken from the Institutional Review Committee (ref. no. 130120205). The sample size was calculated and the convenient sampling method was used. Data were analyzed in the Statistical Package of the Social Sciences version 22. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 5834 visits, 332 (5.96%) (4.70-7.22 at 95% Confidence Interval) patients left against medical advice. The mean age was 36.48 years (3 days-91 years) and males 173 (52.3%) were prone to leave than females. Only 50 (15.1%) cases had well-informed consent with complications documented. Hundred (30.5%) patients had wanted to come on follow up the next day in the out-patient department while 41 (12.4%) had to leave because of financial reasons. Only seven (2.9%) of well-oriented patients gave their consent and the remaining 233 (97.1%) were by the kin present. Only 76 (23%) patients were sent home with a well-documented medicine prescription. Conclusions: The proportion of patients who left against medical advice was more than the studies done in a similar setting.

Nigerian laws on informed consent before a surgical procedure

2019 ◽  
Vol 87 (4) ◽  
pp. 185-187
Author(s):  
Mabel Ijeoma Ezeuko
Keyword(s):  
Informed Consent ◽  
Medical Ethics ◽  
National Health ◽  
Surgical Procedure ◽  
Medical Intervention ◽  
Medical Procedure ◽  
Medical Negligence ◽  
Medical Practitioners ◽  
National Health Act

Informed consent is a process of communication between a clinician and a patient, which results in the patient's agreement to undergo a medical procedure. Rule 19 Part A: Code of Medical Ethics of Nigeria and Section 23 of the National Health Act 2004 prescribe the process of obtaining consent before a medical intervention. The equitable law of torts and/or criminal liabilities that deal with medical negligence should be invoked more often by patients whose right to informed consent is denied by medical practitioners.

scholarly journals The informed consent in clinical trials in school dental units: Impact analysis

2017 ◽  
Vol 63 (3) ◽  
pp. 111-114
Author(s):  
Cristian Funieru ◽  
◽  
Ruxandra Ionela Sfeatcu ◽  
Silviu Mirel Piţuru ◽  
◽  
...  
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
Informed Consent ◽  
Oral Health ◽  
Impact Analysis ◽  
Oral Health Status ◽  
Medical Procedure ◽  
Consent Forms ◽  
Dental Clinics ◽  
Sterilization Process

Introduction. The informed consent is a very important and needful issue for any medical procedure, treatment or clinical trial. In case of minor patients or those without capacity of discernment, the legal owners must sign the informed consent. Materials and methods. The present study is an analysis of the informed consent forms used in 3 studies conducted between 2006 and 2016 in the schools dental units in Bucharest, which had as main objective the examination of the oral health status of schoolchildren aged between 11 and 14 years, as well as many various correlations related to it. Results. The parents approved (69%), refused (17%) their children being part of these studies and others put some conditions. The main reason for the parents’ refusal regarding the clinical trials was the lack of confidence in dental tools’ sterilization process. Conclusions. The informed consent has some limits when dealing with minor patients. It is very important for school dentists, for those who work in private dental clinics or for the examiners in clinical trials that parents always sign the informed consent.

scholarly journals INFORMED CONSENT BETWEEN BIOETHICAL THEORY AND MEDICAL PRACTICE: A CALL FOR ACTIVE VULNERABILITY

2017 ◽  
Vol 15 (2) ◽  
pp. 171
Author(s):  
Marija Selak
Keyword(s):  
Informed Consent ◽  
Medical Practice ◽  
Hospital Treatment ◽  
Medical Procedure ◽  
Contemporary World ◽  
The Awakening ◽  
Self Sufficiency ◽  
Right To Information ◽  
In The Beginning ◽  
Patient’S Perception

The emancipation of bioethics from new medical ethics is a result of the awakening of the role and the rights of patients. Thus, the appearance and realization of informed consent can be seen as an example of the mode in which the contemporary attitude towards medical practice has developed, starting from paternalism and ending in recent attempts for the establishment of a dialogue. Nevertheless, a more detailed analysis of the informed consent practice, with emphasis on the situation in Croatia, shows that this progress is more theoretical, and less related to everyday procedures with patients – encounters with physicians. In view of this, in his PhD thesis “Respecting Patients' Right to Information Regarding Medical Procedure during Hospital Treatment in Croatia” Luka Vučemilo shows that during their stay in hospitals patients do not fully realize their right to be informed. In this paper, we will emphasize the asymmetry in the physician’s and the patient’s perception of informed consent and its formal self-sufficiency. This will serve as confirmation of the fact that informing for the purpose of giving consent to particular medical treatment is not being implemented properly. In order to try to understand the problems concerning the realization of informed consent, in the conclusion of the paper, the same as in the beginning, in order to observe its appearance, we will once again attempt to extend our context and take into consideration the contemporary world-historical situation.

Cardiopulmonary Resuscitation and the Presumption of Informed Consent

2020 ◽  
Vol 20 (4) ◽  
pp. 683-693
Author(s):  
David J. Buckles ◽  
Keyword(s):  
Informed Consent ◽  
High Risk ◽  
Cardiopulmonary Resuscitation ◽  
Medical Intervention ◽  
Ethical Principle ◽  
Medical Procedure ◽  
Do Not Resuscitate ◽  
Potential Harm ◽  
Rule Of Rescue ◽  
Positive Results

Cardiopulmonary Resuscitation (CPR) is the default response for persons who suffer cardiac or pulmonary arrest, except in cases in which there exists a do-not-resuscitate order. This default mindset is based on the rule of rescue and the ethical principle of beneficence. However, due to the lack of efficacy and the high risk of potential harm inherent in CPR, this procedure should not be the default intervention for cardiac or pulmonary arrest. Although CPR is a lifesaving medical intervention, it has limited positive results and the potential for multiple harmful consequences. Given the limited potential of CPR as a medical procedure, clinicians and patients must be educated regarding its limited potential, and procedures must be developed to help determine when it is appropriate as a medical intervention.

Reproductive Choices and Informed Consent: Fetal Interests, Women's Identity, and Relational Autonomy

2011 ◽  
Vol 37 (4) ◽  
pp. 567-623 ◽  
Author(s):  
Pamela Laufer-Ukeles
Keyword(s):  
Informed Consent ◽  
Patient Autonomy ◽  
Medical Profession ◽  
Reproductive Choices ◽  
Legal Reforms ◽  
Fertility Treatments ◽  
Relational Perspective ◽  
Comprehensive Information ◽  
Female Stereotypes ◽  
The One

In this Article, I describe and examine the severe shortcomings in women's autonomy in the context of reproductive choices in the medical arena. The reproductive choices I explore are those choices that involve gestation: abortion, fertility treatments, and interventions during pregnancy. Due to state and medical interests in the fetus, I describe how information conveyed to patients making reproductive choices is biased towards fetal interests, relies on female stereotypes, and is still conveyed with the objective authority of the medical profession. Moreover, reproductive choices implicate women's values and identity interests that reach beyond medical concerns, which are not part of the informed consent doctrine at all. The narrow, individualistic informed consent torts doctrine intended to protect patient autonomy does not do enough in this context to balance bias nor does it mandate discussion of important identity interests and values. Accordingly, I argue that when faced with reproductive choices, women are not provided the balanced and comprehensive information needed to promote their autonomy.In response to the breakdown in patient autonomy I describe, instead of leaving women alone to make choices or regulating in order to protect them from their choices, a broader framework for supporting reproductive choices should be established. In light of the interdependence of woman and fetus, as well as the broader social context shaping these decisions, I argue that a more contextual, relational perspective of autonomy should be the goal of informed consent in the context of reproductive choices. I suggest a number of reforms that aim to optimize patient autonomy from a relational perspective. I suggest a broad, deliberative doctor-patient consultation and legal reforms that create more balance between the pull towards intervention and fetal protection on the one hand, and non-intervention and protection of women's personal identity interests on the other.

scholarly journals Informed Consent in Otolaryngologic Surgery: Case Scenario from a Nigerian Specialist Hospital

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
O. A. Afolabi ◽  
J. O. Fadare ◽  
O. T. Ajiboye
Keyword(s):  
Informed Consent ◽  
Clinical Research ◽  
Surgical Procedure ◽  
Informed Consent Process ◽  
Case Vignette ◽  
Medical Procedure ◽  
Case Scenario ◽  
Technical Tool ◽  
Research And Practice ◽  
Research Participants

Informed consent is a foundational concept necessary for ethical conduct of clinical research and practice. It is a technical tool that shifts the autonomy to decide whether a medical procedure should be performed—from the doctor to the patient. However there is an ongoing discussion in bioethical circles on the level of comprehension of the informed consent process by the patients and research participants. We present this case vignette and the discussion afterwards to explore the question of to what extent a patient comprehends the information given to him/her before a surgical procedure is carried out. In other words, the question being asked here is how informed is informed consent in the context of oto-laryngological practice.

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