Ethics in Healthcare: Informed Consent & Shared Decision Making

1. Current Legal and Ethical Controversies in American Health Care Informed Consent and Shared Decision Making

2. Instructors • Marshall B. Kapp, J.D. M.P.H. • Gregory Todd, J.D., M.D. • Associate Professor, College of Medicine • Program Director, FSU Internal Medicine Residency Program

3. Why Informed Consent and Shared Decision Making? • Autonomy/Self-Determination • Beneficence

4. Elements of Informed Consent • Voluntary • Competent decision maker • Informed

5. What Information Do You Want? • Nature of the problem • Recommended plan • Prognosis, with or without intervention • Reasonable alternatives (always including doing nothing) • Risks of recommended plan and alternatives • Patient’s responsibilities and limitations • Financial considerations? • Other?

6. Consent Forms • Purpose/Effect • Document that the process of communication took place • Protect the health care provider • Does not take the place of proper communication. • Does create a presumption that proper communication took place, shifts burden to patient to prove that communication process was inadequate.

7. Case Discussions • Mr. B, 75-year old man in generally good health • Should physician recommend PSA screening? Should the patient consent?

8. Ms. A, 45-year old woman in good health, no family history of breast cancer • Should physician recommend a screening mammography? Should the patient consent?

9. Ms. C is a 60-year-old, post-menopausal woman with no serious health problems and no significant family history of cardiovascular problems. • Should her physician recommend hormone replacement therapy? • Should Ms. C consent?

10. Shared Decision Making • https://www.youtube.com/watch?v=XPm5iEDEI8Y&list=PL92C4D5A6B4CD339E • https://www.youtube.com/watch?v=5kXso8aPVaw&list=PLB7F6CFCD9AFD5F47&index=14 • https://www.youtube.com/watch?v=6pUeUIwQ6so&index=13&list=PLB7F6CFCD9AFD5F47