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Should the doctor give in to the family’s insistence and give false information? (case study from practice)


Authors: Ivanová Kateřina 1;  Juríčková Lubica 1;  Doležal Adam 2
Authors place of work: Ústav veřejného zdravotnictví, Lékařská fakulta Univerzity Palackého v Olomouci 1;  Ústav humanitních studií, 2. lékařská fakulta Univerzity Karlovy v Praze 2
Published in the journal: Geriatrie a Gerontologie 2023, 12, č. 3: 146-150
Category:

Summary

Ivanová K, Juríčková L, Doležal A. Should the doctor give in to the family’s insistence and give false information? (case study from practice)

Respect for patient’s autonomy is one of the four basic ethical principles applicable to contemporary Western medicine. The patient must provide voluntary informed consent to the treatment procedure. It should reflect the patient’s preferences, requests, and value system. The provider is obliged to ensure that the patient is sufficiently informed in a comprehensible manner about his/her health condition. The aim of the study is to show the method of practical teaching regarding decision-making on the treatment of patients with severe communication problems, including possible solutions. Data are collected through questionnaires in which doctors write down ethically questionable situations from their own practice. Data are consistently generalized and prepared using the story-telling method. Case studies are taught using the Case Based Learning method. The case study is conceived as a story of Mr. Karel (80 years old), who is in the care of his daughter. He is deaf, communicates through sign language, has been diagnosed with Alzheimer’s type dementia, and his eyesight is deteriorating. Cataract surgery is an option to solve the problem. Mr. Karel, however, refuses the procedure. The daughter urges the doctor to tell the father that it is not an operation. In the doctor’s opinion, the operation has a definite benefit for the patient and a very low probability of harm. The result of the case study analysis are expert opinions (medical, ethical and legal).

Keywords:

autonomy – beneficence – communication of information – representative decision-making


Zdroje
  1. Zielina M, Škoda J, Doležal A, et al. The application and understanding of default autonomy in ethically dilemmatic cases presented by Czech medical doctors: an empirical study. In: Tomašovičová J (ed.). The blurring of boundaries in bioscientific discourse. Berlin: Logos Verlag Berlin 2021: 85–104.
  2. Beauchamp TL, Childress JF. Principles of biomedical ethics. 6th ed. New York: Oxford University Press 2009.
  3. Drane JF. The many faces of competency. The Hastings Center Report 1985; 15(2): 17–21.
  4. Doležal A, Doležal T. Kompetence pacienta a informovaný souhlas. Vnitr Lek 2021; 67(1): e49–e55.
  5. Zákon č. 372/2011 Sb., o zdravotních službách a podmínkách jejich poskytování. [online]. [cit. 2023-02-09]. 
  6. Lahey T, Elwyn G. Sliding-scale shared decision making for patients with reduced capacity. AMA Journal of Ethics 2020; 22(5): E358–364. 
  7. Doležal T, Doležal A. Problematika schopnosti poskytnout informovaný souhlas v kontextu posuzování způsobilosti k právnímu jednání. Časopis pro právní vědu a praxi 2021; 29(2): 309–323. 
  8. Wear S. Informed consent: patient autonomy and physician beneficence within clinical medicine. Boston: Kluwer Academic 1993.
  9. Doležal A. Úvod do kazuistické metody (casuistry) a její užití v klinické etice. J Med Law Bioeth 2022; 12(2): 65–78.
  10. Jonsen AR, Toulmin S. The abuse of casuistry: a history of moral reasoning. Berkeley, CA: University of Kalifornia 1988.
  11. Jonsen AR, Siegler M, Winslade WJ. [první vydání v roce 1982]. Klinická etika: praktický přístup k etickým rozhodnutím v klinické medicíně. Praha: Triton 2019. 
  12. Beauchamp TL, Childress JF. Principles of biomedical ethics. 8th ed. New York: Oxford University Press 2019.
  13. Storytelling. [online]. [cit. (2023-02-01]. Dostupné z: https://www.story-telling.cz.
  14. Tučková D, Ivanová K, Lemrová A. Problem-based learning a case-based learning jako diaktické metody ve výuce lékařské etiky. In: Ptáček R, Bartůněk P. Naděje v medicíně. Praha: Grada Publishing 2020: 375–381.
  15. Szopka M, Bardziński F. Konstanz Method of Dilemma: Discussion (KMDD) by Prof. Georg Lind. Ethics in Progress Quarterly 2011; 2(2): 141–150. 
  16. Juríčková L, Ivanová K, Azeem K, et al. Teaching communication with disabled patients using Case-Based Learning – experience from practice. In: Domenech, J, Merello P, Poza E. (eds.). València: Universitat Politècnica de València 2021: 243-251.
  17. Vyhláška č. 98/2012 Sb., o zdravotnické dokumentaci. [online]. [cit. 2023-02-09]. 
  18. Srinivasan M, Wilkes M, Stevenson F, et al. Comparing problem-based learning with case-based learning: effects of a major curricular shift at two institutions. Academic Medicine 2007; 82(1): 74–82. 
  19. Thiel CE, Connelly S, Harkrider L, et al. Case-based knowledge and ethics education: Improving learning and transfer through emotionally rich cases. Science and engineering ethics 2013; 19(1): 265–286. 
  20. Requarth, JA. Informed consent challenges in frail, delirious, demented, and do-not-resuscitate adult patients. J Vasc Interv Radiol 2015; 26(11): 1647–1651. 
  21. Luck T, Rodriguez FS, Wiese B, et al. Advance directives and power of attorney for health care in the oldest-old – results of the AgeQualiDe study. BMC Geriatrics 2017; 17(1):1–13. 
  22. Škoda J, Ivanová K. Etická dilemata u infaustních prognóz: empirická studie. Geri a Gero 2021; 10(4): 210–215.
Štítky
Geriatrics General practitioner for adults Orthopaedic prosthetics

Článok vyšiel v časopise

Geriatrics and Gerontology

Číslo 3

2023 Číslo 3
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