...Queensland Health Guide to Informed Decision-making in Healthcare Disclaimer The information within the Guide to Informed Decision-making in Healthcare is intended as a guide to good clinical practice. The law and service delivery environment is constantly evolving, so while every attempt has been made to ensure the content is accurate, it cannot be guaranteed. The information within this document should not be relied upon as a substitute for other professional or legal advice. ISBN 9781921707391 ©State of Queensland (Queensland Health) 2011 First edition February 2012 This work is licensed under a Creative Commons Attribution Non-Commercial 2.5 Australian license. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc/2.5/au/ In essence, you are free to copy, communicate and adapt the work for non-commercial purposes, as long as you attribute the Patient Safety and Quality Improvement Service, Queensland Health and abide by the license terms. For further information, contact: Informed Consent Program Manager Patient Safety and Quality Improvement Service Centre for Healthcare Improvement, Queensland Health PO Box 152 Herston Queensland 4029 tel (+61) (07) 3646 9715 psq@health.qld.gov.au www.health.qld.gov.au/chi/psq/ For permission beyond the scope of this license contact: Intellectual property Officer Queensland Health GPO Box 48 Brisbane Queensland 4001 tel (+61) (07) 3234 1479 ip_officer@health.qld.gov.au Forward Patient-centred care is widely...
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...Nurses Manage Patients Who Refuse Nursing Care Procedures Grand Canyon University: NRS 433V March 9, 2014 Nurses Mange Patients Who Refuse Nursing Care Procedures This paper will critique a qualitative research study about how nurses manage patients who refuse nursing care procedures. These articles also explains how nurses view informed consent as not being essential to nursing care procedures. PROBLEM STATEMENT The clinical problem being examined in the research study is the way in which nurses obtain consent prior to administering nursing care procedures, and the way nurses manage patients who refuse any nursing care procedures. By stating that nurses “do not regard obtaining consent as an absolute requirement” also stating that “consent is preferred but no considered essential” the significance is established and a clinical problem identified (Aveyard, 2004). The author identifies the need for further education of nurses on the need to obtain informed consent for nursing care procedures, and the need for more research of this topic. The role of persuasion in situations of informed consent has been widely commented on. Many commentators argue that the health care provider has a duty not only to give information but also to persuade the recipient of care to accept the course of action considered most appropriate for the patients’ safety. PURPOSE and RESEARCH QUESTIONS The study clearly identifies the aim of the study as “to examine the way in which...
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...AMA's Code of Medical Ethics has been the authoritative ethics guide for practicing physicians. Ethics in Hand are pocket-sized guides to the Code of Medical Ethics for physicians and medical students. The Code articulates the enduring values of medicine as a profession. As a statement of the values to which physicians commit themselves individually and collectively, the Code is a touchstone for medicine as a professional community. It defines medicine’s integrity and the source of the profession’s authority to self-regulate. At the same time, the Code of Medical Ethics is a living document, evolving as changes in medicine and the delivery of health care raise new questions about how the profession's core values apply in physicians' day to day practice. The Code links theory and practice, ethical principles and real world dilemmas in the care of patients. The next time you hear a monotheist tell a non-believer that morals come from the Bible or that moral reasoning cannot provide an ethical code of conduct; point them to the body of Medical Ethics. I find Medical Ethics to be so fascinating because we are required to implement our moral reasoning in order to discover the best course of action in a difficult situation. Physicians are bound by the Hippocratic Oath, dating back to the late 5th century BCE. The original oath was sworn to the Greek gods, including Apollo, and...
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...other workers. In health care, the right of patients to make decisions about their medical care without their health care provider trying to affect the decision. Patient autonomy will allow for health care providers to inform or educate the patient but does not allow the health care provider to make decision for the patients. Autonomy is important for medical ethics because every patient or human being of sound mind has a right to determine what should be done with his own body whether refuse or accept the procedure that doctors offer to patients. Informed consent is the process by which the health care provider tells or discloses appropriate information to a patient so that the patient can make a choice to accept or refuse the treatment. The goal or the purpose of having informed consent is to prove that the patient have been fully informed of available treatment options and their risks and benefits. Informed consent relates to the principle of respect autonomy because the health care provider must take his or her time to explain every single detail of the procedure to the patient before operating on the patient. A health care provider must answer all the questions given by the patient and respect their views, decisions and rights so long as their thoughts and actions do not seriously harm other persons. A health care provider should always respect the individuals’ autonomy and their informed consent. However, there are moral problems raised by informed consent....
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...CENTRO ESCOLAR UNIVERSITY UNIT IX Legal Aspects Of End-of-Life Care Clinical Instructor Informed consent * Refers to the knowledge or information about and the consent to a particular form of medical treatment is administered. The information should include the risks and advantages of any medical treatment that concerns the patient. * Is an agreement by a client to accept a course of treatment or a procedure after being provided complete information, including the benefits and risks of treatment, alternatives to the treatment and prognosis if not treated by a health care provider. Four Major Elements of Informed Consent 1. Competence. This refers to a patient’s capacity for decision-making. One is considered competent when (a) one has made a decision (b) one has the capacity to justify one’s choice – competence here requires some process of deliberation, justification, and an articulation of why one has made this particular choice; (c) one does not only justify one’s choice but does so in a reasonable manner. 2. Disclosure. This refers to the content of what a patient is told or informed about during the consent negotiation. Then patient must be informed and must understand the information concerning medical treatment to be undertaken, so that a moral decision can be made. The disclosure of the information must be conducted in such a way that the patient understands the whole process and is aware of the possible outcomes of his or her normal...
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...Informed consent Name Course Date Informed consent Informed consent is the procedure of getting permission to take part in a research study or medical procedure founded on access to all vital and easily understandable information about the consequences of participation in terms of benefits and harms (Dolgoff et al, 2009). A healthcare provider may demand informed consent from a patient before providing care or a researcher may request it from a participant before enrolling the individual into a research trial. Informed consent is based on guidelines provided by research and medical ethics. To give informed consent, the person involved must have sufficient reasoning faculties and have all the relevant facts. However, not all individuals may have capacities for informed consent due to impairments to reasoning and judgment such as mental immaturity, severe intellectual disabilities, mental illnesses, high stress levels, being in a coma, Alzheimer’s disease, and severe sleep deprivation. Medical and research actions may be carried out due to lack of informed consent. When a person is considered unable to give informed consent, another person can be authorized to give consent on behalf of that person (Manson & O'Neill, 2007). For instance, legal guardians or parents may give informed consent for young children and the mentally ill. In case a person is given insufficient information to make a reasoned decision, severe ethical issues may arise. In clinical trials...
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...INFORMED CONSENT IN EMERGENCY SITUATIONS 1 INFORMED CONSENT IN EMERGENCY SITUATIONS IVA SHIELDS LEGAL & REG ISSUES-HLTH INFO / HIT 220 PROFESSOR: ANDREA THOMAS INFORMED CONSENT IN EMERGENCY SITUATIONS 2 A patient has the legal right to be informed and knowledgeable concerning any procedure performed by all medical personnel. The fact that an emergency situation has occurred does not change those rights. Being in a vulnerable state of mind when facing an emergency situation can be scary enough without facing the situation uninformed and unknowledgeable as to how the circumstances may affect you and your family. We, the patient or patients are protected by rights that are put in to place to help reassure us that we will receive the best care possible, without the fear being taken advantage of or our lives taken for granted. Informed consent is defined as a voluntary agreement given by a person or a patients' responsible proxy (for example, a parent) for participation in a study, immunization program, treatment regimen, invasive procedure, etc., after being informed of the purpose, methods, procedures, benefits, and risks. The essential criteria of informed consent are that the subject has both knowledge...
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...Health Care Organizational Ethics Plan Amanda Paschal Ethics and Decision Making in Health Care June 6, 2016 Contents Introduction 3 Theoretical aspects of organizational policy 3 Ethical Decisions and Judgment 5 Informed Consent 6 Regulatory issues and policies of informed consent are addressed. 7 Finance issues 8 Patient care issues 9 Human resources issues 9 Legal issues 10 Regulatory issues 11 Protocols to address patient safety issues 12 Protocols to address patient access issues 14 Ethical responsibility for transparency in health care 15 End of life and quality of life issues 17 Alternatives in decision-making for health care administrators to resolve ethical dilemmas within the organization 19 Conclusion 20 References 22 Introduction Healthcare is the treatment of health related issues such as prevention, diagnosis, treatment and prevention. Healthcare is provided by Doctors, nurses and other licensed healthcare professionals. Who work at an office or a facility which would be a healthcare organization. By definition “An organization, by its most basic definition, is an assembly of people working together to achieve common objectives through a division of labor, people form organizations because individuals have limited abilities. An organization provides a means of using individual strengths within a group to achieve more than can be accomplished by the aggregate efforts of group members working individually. Business organizations (in market economies)...
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...Lesson 3 – Informed Consent, Substitute Decision-Making, and the Family Centered Approach * It should be noted that a choice might properly require only low/ minimal competence, even though its expected risks exceed its expected benefits or it is more generally a high-risk treatment, because all other available alternatives have substantially worse risk/benefit ratios. * Thus, according to the concept of competence endorsed here, a particular individual’s decision-making capacity at a given time may be sufficient for making a decision to refuse a diagnostic procedure when forgoing the procedure does not carry a significant risk, although it would not necessarily be sufficient for refusing a surgical procedure that would correct a life-threatening condition * The greater the risk relative to other alternatives—where risk is a function of the severity of the expected harm and the probability of its occurrence—the greater the level of communication, understanding, and reasoning skills required for competence to make that decision. * It is not always true, however, that if a person is competent to make one decision, then he or she is competent to make another decision so long as it involves equal risk. * Even if the risk is the same, one decision may be more complex, and hence require a higher level of capacity for understanding options and reasoning about consequences. * The evaluation of the patient’s decision-making will seek to assess how well...
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...| Informed Consent in Emergency Situations | By | | Liz Marotz | 3/1/2016 | | I. Introduction A. Explanation of an Informed Consent B. Type of Informed Consent C. How to use an Informed Consent in Emergency Situations II. Elements of Full informed consent A. Assessment of patient understanding B. The Nature of the decision/Procedure III. Interventions that require Informed Consent A. Cancer Screening test B. Clinical Decision IV. Waive Informed Consent Form A. Reason to waive B. Who gives the approval of waiver V. Conclusion A. Summary Informed consent means that permission is granted in the knowledge of the possible consequences, typically that which is given by a patient to a doctor for treatment with full knowledge of the possible risks and benefits. However, informed consent in an emergency situation can only be presumed rather than obtained when the patient is unconscious or incompetent and no surrogate decision maker is available and the emergency interventions will prevent death or disability. In general, the patient's presence in the hospital ward, ICU or clinic does not represent implied consent to all treatment and procedures. The patient's wishes and values may be quite different from the values of the physician. While the principle of respect for the patient obligates the physician to do their best to include the patient in the health care decisions that affect the patient’s life and body, the principle...
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...She was treated by Dr. Craig Jackson, a neonatologist employed by the University of Washington. Emma suffered from hyperbilirubinemia, or jaundice, caused by elevated levels of bilirubin, a substance that is released into the bloodstream. Jaundice is not uncommon among infants as approximately a third or more of all newborns at the intensive care unit at Children’s hospital have jaundice. Greatly elevated bilirubin levels can result in permanent in brain damage. When Emma was admitted to Children’s Hospital, her serum bilirubin level was 4.2 micrograms per deciliter. It gradually increased to as high as 22.0 mcg/dl on January 7, 1988, then decreased to 5.7 mcg/dl on January 18, 1988. The type of jaundice Emma experience is generally treated with phototherapy. More serious cases are treated with a transfusion of all the blood in the infant’s body, a treatment entailing greater risks including cardiac arrhythmia, bleeding, bacterial infection and the development of air bubbles in the circulatory system. Dr. Martin prescribed phototherapy for Emma, which was unsuccessful, and Emma suffered brain damage. The Brewster’s allegedly were not informed of the risks associated with high bilirubin levels and did not know that Emma’s developmental problems were caused by the high bilirubin levels until almost two years after treatment. (HC Legal Writing Assignment). Writer’s Opinion if the Jury Should find Dr. Jackson Liable The writer of this paper does feel that the jury...
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...rights seeks “to help patients feel more confident in the US health care system. The Bill of Rights: assures that the health care system is fair and it works to meet patients' needs, gives patients a way to address any problems they may have, encourage patients to take an active role in staying or getting healthy, stress the importance of a strong relationship between patients and their health care providers, to stress the key role patients play in staying healthy by laying out rights and responsibilities for all patients and health care providers.” The essential goal is to let patients know the treatment options proposed by the medical professional tending to them so that the patient can consent to treatment that they feel is right for them. Under the bill of rights, patients the right to talk privately with health care providers and to have your health care information protected. According to [ (The AGS Foundation for Health in Aging) ], “Except under extraordinary circumstances, you have the legal right to make decisions about your body and your medical care. Ideally, these decisions should be made by capable, informed patients after discussion with their physicians and other health care providers.” Identify and explain at least three ethical considerations: The ethical considerations are that the Nurse Nancy is taking it upon herself to give the patient unnecessary drugs to end her patient’s life, without the consent of the patient or her family. Another ethical consideration...
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...Ethical Practice Health care professionals are held to legal standards, as well as high standards of ethics which govern their practice. This chapter will introduce the student to the basics of health care ethics and legal practice. Ethics Ethics are the practices, beliefs, and standards of behavior that guide practice as health care professionals. Four basic ethical principles: Autonomy refers to the right to make one’s own decisions. Health care professionals must respect a patient’s or client’s right to make decisions, even when the professional disagrees with the decisions or it may not be in the client’s best interest. Nonmaleficence means to do no harm. This principle is the basis for most health care codes of ethics. Harm...
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...Table of Contents I. Informed Consent A. Patient B. Healthcare Professional C. Consent for others D. Competencies II. Consent Forms A. Emergencies/Non-Emergencies B. Authorization C. End of Life Decisions III. Legal A. Processes B. Malpractices IV. Conclusion V. References The concept of the informed consent is always a subject that is uncertain. An informed consent can be presented as an understanding of the fact and implications. When giving informed consent, the person must have all the facts at the time of consent is needed. Concepts It is extremely important that a patient must be provided all the information needed to give consent and not encouraged or forced by any medical staff member. The patient should also be in right mind before consenting to any procedure. If the patient is under the influence of medication, the consent will have to be given to the next of kin. The physician is responsible for providing all details of the procedure and treatment that will occur to the patient. This conversation should also be noted in the patient’s medical record. The physician has the right to assign another staff member to obtain the informed consent form, but only if the physician has performed the requirements needed. When consent is needed from other family members, the physician is required to provide the family member the details of the treatment. Also, the patient must consent to render his/her voice to...
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...Analyze the legal issues related to informed consent and refusal Informed consent is an essential part of the treatment process in psychology. Legally it protects both the psychologist and the individual who will be receiving professional services. According to Pope and Vasquez (2007), informed consent provides the client and the therapist the opportunity to understand his or her legal rights and that they each have an equal vested interest in the treatment process. Pope and Vasquez (2007) also stated that informed consent is a decision making-process that gives the client the... The informed consent is the agreement between two parties to work collaboratively (Pope & Vasquez, 2007). In psychology, the client signs the consent form to allow treatment from the psychologist who may include testing, treatment, and initial psychological assessment. The patients have the right to their information; in terms of benefits, alternative treatments and about the risks. If the patient does not understand what he or she is giving permission to, he or she can allow an authorized decision-maker. The law requires that all persons take reasonable steps to clarify and communicate adequately with their patients about their risks and benefits. The informed consent is basically the understanding and justification of power that should not be abused intentionally or accidentally (Pope & Vasquez, 2007). The informed refusal is when a patient is refusing care; because of legal issues, trust, infectious...
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