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The silent world of doctor and patient

Baltimore: Johns Hopkins University Press (1984)

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  1. Probability and Informed Consent.Nir Ben-Moshe, Benjamin A. Levinstein & Jonathan Livengood - 2023 - Theoretical Medicine and Bioethics 44 (6):545-566.
    In this paper, we illustrate some serious difficulties involved in conveying information about uncertain risks and securing informed consent for risky interventions in a clinical setting. We argue that in order to secure informed consent for a medical intervention, physicians often need to do more than report a bare, numerical probability value. When probabilities are given, securing informed consent generally requires communicating how probability expressions are to be interpreted and communicating something about the quality and quantity of the evidence for (...)
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  • Knowledge about and attitudes toward medical informed consent: a Lebanese population survey.Mary Deeb, Dana Alameddine, Rasha Abi Radi Abou Jaoudeh, Widian Laoun, Julian Maamari, Rawan Honeini, Alain Khouri, Fadi Abou-Mrad, Nassib Elia & Aniella Abi-Gerges - 2024 - Ethics and Behavior 34 (2):89-103.
    As Medicine shifts from a paternalistic practice to a patient-centered approach, the concept of medical informed consent (IC) has evolved to safeguard patient autonomy. However, its current implementation still presents many challenges in clinical practice. We assessed the knowledge and attitudes of the general Lebanese population regarding the IC process as well as their sociodemographic and medical correlates. An anonymous online survey was distributed to the Lebanese population using social media channels. A sample of 500 adults with an average age (...)
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  • Informed Consent: What Must Be Disclosed and What Must Be Understood?Joseph Millum & Danielle Bromwich - 2021 - American Journal of Bioethics 21 (5):46-58.
    Over the last few decades, multiple studies have examined the understanding of participants in clinical research. They show variable and often poor understanding of key elements of disclosure, such as expected risks and the experimental nature of treatments. Did the participants in these studies give valid consent? According to the standard view of informed consent they did not. The standard view holds that the recipient of consent has a duty to disclose certain information to the profferer of consent because valid (...)
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  • The Construction of Lay Expertise: AIDS Activism and the Forging of Credibility in the Reform of Clinical Trials.Steven Epstein - 1995 - Science, Technology and Human Values 20 (4):408-437.
    In an unusual instance of lay participation in biomedical research, U.S. AIDS treatment activists have constituted themselves as credible participants in the process of knowledge construction, thereby bringing about changes in the epistemic practices of biomedical research. This article examines the mechanisms or tactics by which these lay activists have constructed their credibility in the eyes of AIDS researchers and government officials. It considers the inwlications of such interventions for the conduct of medical research; examines some of the ironies, tensions, (...)
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  • The Relationship Between Uncertainty and Affect.Eric C. Anderson, R. Nicholas Carleton, Michael Diefenbach & Paul K. J. Han - 2019 - Frontiers in Psychology 10:469966.
    Uncertainty and affect are fundamental and interrelated aspects of the human condition. Uncertainty is often associated with negative affect, but in some circumstances it is associated with positive affect. In this paper, we review different explanations for the varying relationship between uncertainty and affect. We identify “mental simulation” as a key process that links uncertainty to affective states. We suggest that people have a propensity to simulate negative outcomes, which results in a propensity towards negative affective responses to uncertainty. We (...)
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  • The Value of Consent for Clinical Research Does Not Always Hinge on Understanding.Neal W. Dickert - 2019 - American Journal of Bioethics 19 (5):20-22.
    Volume 19, Issue 5, May 2019, Page 20-22.
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  • Trust in health care and vaccine hesitancy.Elisabetta Lalumera - 2018 - Rivista di Estetica 68:105-122.
    Health care systems can positively influence our personal decision-making and health-related behavior only if we trust them. I propose a conceptual analysis of the trust relation between the public and a healthcare system, drawing from healthcare studies and philosophical proposals. In my account, the trust relation is based on an epistemic component, epistemic authority, and on a value component, the benevolence of the healthcare system. I argue that it is also modified by the vulnerability of the public on healthcare matters, (...)
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  • Informed Consent.Jean-Pierre Clero - 2016 - Postmodern Openings 7 (2):15-23.
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  • Genetic Research as Therapy: Implications of "Gene Therapy" for Informed Consent.Larry R. Churchill, Myra L. Collins, Nancy M. R. King, Stephen G. Pemberton & Keith A. Wailoo - 1998 - Journal of Law, Medicine and Ethics 26 (1):38-47.
    In March 1996, the General Accounting Office (GAO) issued the reportScientific Research: Continued Vigilance Critical to Protecting Human Subjects.It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always cleartoclinicians. Controversy (...)
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  • Should Liability Play a Role in Social Control of Biobanks?Lamy I. Palmer - 2005 - Journal of Law, Medicine and Ethics 33 (1):70-78.
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  • Placebos, Full Disclosure, and Trust: The Risks and Benefits of Disclosing Risks and Benefits.Peter H. Schwartz - 2015 - American Journal of Bioethics 15 (10):13-14.
    Consider the following patient: a 40-year-old man who has had back pain that radiates down his left leg, on and off for 2 months. He performs his normal activities and does not have any “red flag”...
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  • Placebo Effects and Informed Consent.Mark Alfano - 2015 - American Journal of Bioethics 15 (10):3-12.
    The concepts of placebos and placebo effects refer to extremely diverse phenomena. I recommend dissolving the concepts of placebos and placebo effects into loosely related groups of specific mechanisms, including (potentially among others) expectation-fulfillment, classical conditioning, and attentional-somatic feedback loops. If this approach is on the right track, it has three main implications for the ethics of informed consent. First, because of the expectation-fulfillment mechanism, the process of informing cannot be considered independently from the potential effects of treatment. Obtaining informed (...)
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  • Rufus of Ephesus and the Patient's Perspective in Medicine.Melinda Letts - 2014 - British Journal for the History of Philosophy 22 (5):996-1020.
    Rufus of Ephesus's treatise Quaestiones Medicinales is unique in the known corpus of ancient medical writing. It has been taken for a procedural handbook serving an essentially operational purpose. But with its insistent message that doctors cannot properly understand and treat illnesses unless they supplement their own knowledge by questioning patients, and its distinct appreciation of the singularity of each patient's experience, Rufus's work shows itself to be no mere handbook but a treatise about the place of questioning in the (...)
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  • Presumed Consent Models and Health Information Exchanges: Hard Nudges and Ambiguous Benefits.Ricky T. Munoz, Mark D. Fox & Michael R. Gomez - 2013 - American Journal of Bioethics 13 (6):14-15.
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  • (1 other version)Informed Consent: Its History, Meaning, and Present Challenges.Tom L. Beauchamp - 2011 - Cambridge Quarterly of Healthcare Ethics 20 (4):515-523.
    The practice of obtaining informed consent has its history in, and gains its meaning from, medicine and biomedical research. Discussions of disclosure and justified nondisclosure have played a significant role throughout the history of medical ethics, but the term “informed consent” emerged only in the 1950s. Serious discussion of the meaning and ethics of informed consent began in medicine, research, law, and philosophy only around 1972.
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  • Placebos in Clinical Practice and the Power of Suggestion.Anthony Vernillo - 2009 - American Journal of Bioethics 9 (12):32-33.
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  • Silence about Screening.Peter H. Schwartz - 2007 - American Journal of Bioethics 7 (7):46-48.
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  • Defining the Subject of Consent in DNA Research.Gordon R. Mitchell - 2001 - Journal of Medical Humanities 22 (1):41-53.
    The advent of population-specific genomic research has prompted calls for invention of informed consent protocols that would treat entire social groups as research subjects as well as endow such groups with authority as agents of consent. Critics of such an unconventional ethical norm of group consent fear the rhetorical effects of approaching social groups with offers to participate in dialogues about informed consent. Addressing a specific population as the collective subject of genomic research, on this logic, adds currency to the (...)
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  • Malpractice arising from negligent psychotherapy: Ethical, legal, and clinical implications of Osheroff V. chestnut Lodge.Wendy L. Packman, Mithran G. Cabot & Bruce Bongar - 1994 - Ethics and Behavior 4 (3):175 – 197.
    Traditionally, there have been few legal actions brought against psychotherapists that allege negligent psychotherapy and negligent treatment of psychiatric disorders. However, in the case of Osheroff v. Chestnut Lodge, a patient-physician (Dr. OsheroE) sued Chestnut Lodge, a private psychiatric facility, for negligence based on the staff's decision to apply a psychodynamic model of treatment (through psychotherapy) and not a biological model. The case sparked a heated debate between adherents of the psychodynamic model and those of the biological model. This article (...)
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  • Trust: The scarcest of medical resources.Patricia Illingworth - 2002 - Journal of Medicine and Philosophy 27 (1):31 – 46.
    In this paper, I claim that the doctor-patient relationship can be viewed as a vessel of trust. Nonetheless, trust within the doctor-patient relationship has been impaired by managed care. When we conceive of trust as social capital, focusing on the role that it plays in individual and social well-being, trust can be viewed as a public good and a scarce medical resource. Given this, there is a moral obligation to protect the doctor-patient relationship from the cost-containment mechanisms that compromise its (...)
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  • Spirituality: Respect but don't reveal.Daniel S. Goldberg & Howard Brody - 2007 - American Journal of Bioethics 7 (7):21 – 22.
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  • The Church, the State, and Vaccine Policy.Saad B. Omer, Douglas J. Opel, Tyler Tate & Robert A. Bednarczyk - 2017 - American Journal of Bioethics 17 (4):50-52.
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  • Paths to Reducing Medical Injury: Professional Liability and Discipline vs. Patient Safety — And the Need for a Third Way.Randall R. Bovbjerg, Robert H. Miller & David W. Shapiro - 2001 - Journal of Law, Medicine and Ethics 29 (3-4):369-380.
    Too many patients are injured in the course of care. Clinicians may mistakenly cause new harm to a patient or fail to take established steps to improve the presenting condition. Medical institutions within which they work may lack mechanisms to reduce errors or prevent them from harming patients. Many, perhaps even most, injuries are preventable, probably numbering in the hundreds of thousands a year for hospital care alone. Long ignored by medical practitioners and health-care payers and little appreciated by the (...)
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  • Jay Katz: Preface to a Celebration.Alexander Morgan Capron - 1988 - Journal of Law, Medicine and Ethics 16 (3-4):153-156.
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  • Patients' Interests and Clients' Wishes: Physicians and Lawyers in Discord.Bernard M. Dickens - 1987 - Journal of Law, Medicine and Ethics 15 (3):110-117.
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  • Mandatory Disclosure and Medical Paternalism.Emma C. Bullock - 2016 - Ethical Theory and Moral Practice 19 (2):409-424.
    Medical practitioners are duty-bound to tell their patients the truth about their medical conditions, along with the risks and benefits of proposed treatments. Some patients, however, would rather not receive medical information. A recent response to this tension has been to argue that that the disclosure of medical information is not optional. As such, patients do not have permission to refuse medical information. In this paper I argue that, depending on the context, the disclosure of medical information can undermine the (...)
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  • Free Choice and Patient Best Interests.Emma C. Bullock - 2016 - Health Care Analysis 24 (4):374-392.
    In medical practice, the doctrine of informed consent is generally understood to have priority over the medical practitioner’s duty of care to her patient. A common consequentialist argument for the prioritisation of informed consent above the duty of care involves the claim that respect for a patient’s free choice is the best way of protecting that patient’s best interests; since the patient has a special expertise over her values and preferences regarding non-medical goods she is ideally placed to make a (...)
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  • The Ethics and Governance of Medical Research: What does regulation have to do with morality?Richard Ashcroft - 2003 - New Review of Bioethics 1 (1):41-58.
    (2003). The Ethics and Governance of Medical Research: What does regulation have to do with morality? New Review of Bioethics: Vol. 1, No. 1, pp. 41-58.
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  • A Legacy of Silence: Bioethics and the Culture of Pain. [REVIEW]Ben A. Rich - 1997 - Journal of Medical Humanities 18 (4):233-259.
    For over 20 years the medical literature has carefully documented the undertreatment of all types of pain by physicians. During this same period, as the field of bioethics came of age, the phenomenon of undertreated pain received almost no attention from the bioethics literature. This article takes bioethicists to task for failing to recognize the undertreatment of pain as a major ethical, and not merely a clinical, failing of the medical profession. The nature and extent of the problem of undertreated (...)
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  • Masks in Medicine: Metaphors and Morality.Lindsey Grubbs & Gail Geller - 2021 - Journal of Medical Humanities 42 (1):103-107.
    We have never been so aware of masks. They were in short supply in the early days of COVID-19, resulting in significant risk to health care workers. Now they are highly politicized with battles about mask-wearing protocols breaking out in public. Although masks have obtained a new urgency and ubiquity in the context of COVID-19, people have thought about both the literal and metaphorical role of masks in medicine for generations. In this paper, we discuss three such metaphors—the masks of (...)
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  • From the SWS President: On Ignorance, Knowledge, and Power.Rose Weitz - 1996 - Gender and Society 10 (5):502-504.
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  • The Unbearable Requirement of Informed Consent.Ellen Wright Clayton - 2019 - American Journal of Bioethics 19 (5):19-20.
    In the spirit of full disclosure, I have been a member of the Delphi panels discussed in this article (Beskow and Weinfurt 2019) since their inception and was one of the people who was recently int...
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  • Ethical and Scientific Issues in Cancer Screening and Prevention.Anya Plutynski - 2012 - Journal of Medicine and Philosophy 37 (3):310-323.
    November 2009’s announcement of the USPSTF’s recommendations for screening for breast cancer raised a firestorm of objections. Chief among them were that the panel had insufficiently valued patients’ lives or allowed cost considerations to influence recommendations. The publicity about the recommendations, however, often either simplified the actual content of the recommendations or bypassed significant methodological issues, which a philosophical examination of both the science behind screening recommendations and their import reveals. In this article, I discuss two of the leading ethical (...)
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  • Requena Meana, Pablo. ¡Doctor, no haga todo lo posible! De la limitación a la prudencia terapéutica.Fermín J. González-Melado - 2018 - Persona y Bioética 22 (1):158-165.
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  • Fragility, uncertainty, and healthcare.Wendy A. Rogers & Mary J. Walker - 2016 - Theoretical Medicine and Bioethics 37 (1):71-83.
    Medicine seeks to overcome one of the most fundamental fragilities of being human, the fragility of good health. No matter how robust our current state of health, we are inevitably susceptible to future illness and disease, while current disease serves to remind us of various frailties inherent in the human condition. This article examines the relationship between fragility and uncertainty with regard to health, and argues that there are reasons to accept rather than deny at least some forms of uncertainty. (...)
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  • The Metamorphosis of Managed Care: Implications for Health Reform Internationally.Marc A. Rodwin - 2010 - Journal of Law, Medicine and Ethics 38 (2):352-364.
    Many writers suggest that managed care had a brief life and that we are now in a post-managed care era. Yet managed care has had a long history and continues to thrive. Writers also often assume that managed care is a fixed entity, or focus on its tools, rather than the context in which it operates and the functions it performs. They overlook that managed care has evolved and neglect to examine the role that it plays in the health system.This (...)
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  • The Values History: An Innovation in Surrogate Medical Decision-Making.Pam Lambert, Joan McIver Gibson & Paul Nathanson - 1990 - Journal of Law, Medicine and Ethics 18 (3):202-212.
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  • Protection of Research Subjects: Do Special Rules Apply in Epidemiology?A. M. Capron - 1991 - Journal of Law, Medicine and Ethics 19 (3-4):184-190.
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  • Patient Confidentiality and the Surrogate's Right to Know.Lynn A. Jansen & Lainie Friedman Ross - 2000 - Journal of Law, Medicine and Ethics 28 (2):137-143.
    Physicians treating newly incapacitated patients often must navigate surrogate decision-makers through a difficult course of treatment decisions. Such a process can be complex. Physicians must not only explain the medical facts and prognosis to the surrogate, but also attempt to ensure that the surrogate arrives at decisions that are consistent with the patient's own values and wishes. Where these values and wishes are unknown, physicians must help surrogates make decisions that reflect the patient's best interests.
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  • A Tool for Teaching and Scholarship: A Review of Lawrence Gostin's Public Health Law: Power, Duty, Restraint. [REVIEW]Bernard M. Dickens - 2002 - Journal of Law, Medicine and Ethics 30 (2):162-169.
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  • Liability Reform Should Make Patients Safer: “Avoidable Classes of Events” are a Key Improvement.Randall R. Bovbjerg & Laurence R. Tancredi - 2005 - Journal of Law, Medicine and Ethics 33 (3):478-500.
    Too many patients are injured in the course of medical care. This truth is as distressing now as it was four years ago when it began an article in this journal’s last similar symposium. Many or most injuries seem preventable. Yet today’s systems of care and of oversight of care too often fail to prevent them, despite generations of increasing legal intervention. Few injuries are litigated, even fewer addressed through medical peer review or state disciplinary authorities. The Institute of Medicine’s (...)
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  • The Silent World of Collaborators from Different Disciplines.Joseph Goldstein - 1988 - Journal of Law, Medicine and Ethics 16 (3-4):248-255.
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  • A "Dignitray Tort" as a Bridge between the Idea of Informed Consent and the Law of Informed Consent.Alan Meisel - 1988 - Journal of Law, Medicine and Ethics 16 (3-4):210-218.
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  • Research with Human Subjects as a Paradigm in Teaching.Larry I. Palmer - 1988 - Journal of Law, Medicine and Ethics 16 (3-4):183-189.
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  • Autonomy and Paternalism in Health Policy: Currents in Contemporary Bioethics.Mark A. Rothstein - 2014 - Journal of Law, Medicine and Ethics 42 (4):590-594.
    In the United States the delivery of health care traditionally has been hierarchical and strictly controlled by physicians. Physicians typically provided patients with little information about their diagnosis, prognosis, and treatment plan; patients were expected to follow their physicians’ orders and ask no questions. Beginning in the 1970s, with the widespread adoption of the doctrine of informed consent to treatment, the physician-patient relationship began to be more collaborative, although the extent of the change has been subject to debate. At a (...)
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  • (1 other version)Patients’ perceived purpose of clinical informed consent: Mill’s individual autonomy model is preferred.Muhammad M. Hammami, Eman A. Al-Gaai, Yussuf Al-Jawarneh, Hala Amer, Muhammad B. Hammami, Abdullah Eissa & Mohammad A. Qadire - 2014 - BMC Medical Ethics 15 (1):2.
    Although informed consent is an integral part of clinical practice, its current doctrine remains mostly a matter of law and mainstream ethics rather than empirical research. There are scarce empirical data on patients’ perceived purpose of informed consent, which may include administrative routine/courtesy gesture, simple honest permission, informed permission, patient-clinician shared decision-making, and enabling patient’s self decision-making. Different purposes require different processes.
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  • Medical education: The training of ethical physicians.Raphael Sassower - 1990 - Studies in Philosophy and Education 10 (3):251-261.
    This paper suggests that medical education be revised to assist in diffusing potential ethical dilemmas that arise during health care provision. A revised medical education would emphasize the role of the humanities in the training of physicians, especially in light of recent critiques of the canonical scientific model in general, and more specifically in the use of that model for medical training and practice.
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  • How not to think: medical ethics as negative education. [REVIEW]Ruth Cigman - 2013 - Medicine, Health Care and Philosophy 16 (1):13-18.
    An implicit rationale for ethics in medical schools is that there is a perceived need to teach students how not to think and how not to act, if they are to avoid a lawsuit or being struck off by the GMC. However, the imperative to keep within the law and professional guidance focuses attention on risks to patients that can land a doctor in trouble, rather than what it means to treat a patient humanely or well. In this paper I (...)
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  • Transparency and Self-Censorship in Shared Decision-Making.Howard Brody - 2007 - American Journal of Bioethics 7 (7):44-46.
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