Law, University of Michigan, Ann Arbor, Michigan, USA.
Cardiology, Aurora, Hobart, Wisconsin, USA
Postgrad Med J. 2020 Nov;96(1141):708-710. doi: 10.1136/postgradmedj-2019-137278.
Medical informed choice is essential for a physician meeting their fiduciary duty when proposing medical and surgical actions, and necessary for a patient to consent or cull the outlined therapeutic approaches. Informed choice, as part of a shared decision-making model, allows widespread give-and-take of ideas between the patient and physician. This sharing of ideas results in a partnership for decision-making and a responsibility for medical and surgical outcomes.Informed choice is indispensible to the patient education process that meets the desired outcome of any covenant-an offer of and acceptance of the proposed treatment. The covenant anchors a true patient-physician partnership with parity and equality in decision-making and medical/surgical outcomes.Medical informed choice flows from ethical and legal principles necessary to meet the acknowledged standard of care. This is codified by statute and fortified in general common law. This espouses a fiduciary relationship where the patient and physician understand and accede to the degree of autonomy the patient requests.The growth of an equal patient-physician relationship requires time. There is no alternative to the time variable when developing a physician-patient relationship. Despite physicians being under pressures to perform more clinical and administrative duties in less time in the corporate model of medicine, time remains the most critical variable when considering informed choice and shared decision-making. Videos, pamphlets and alternate healthcare providers cannot and should not substitute for physician time.
医学知情选择对于医生在提出医疗和手术措施时履行信托责任至关重要,对于患者同意或淘汰所概述的治疗方法也必不可少。知情选择作为共同决策模式的一部分,允许患者和医生之间广泛地交流想法。这种思想的交流导致了决策的伙伴关系,并对医疗和手术结果负责。知情选择对于满足任何契约——提供和接受所提议的治疗的期望结果的患者教育过程是不可或缺的。该契约以平等和决策以及医疗/手术结果的平等为基础,确立了真正的医患伙伴关系。医学知情选择源自满足公认护理标准所需的道德和法律原则。这由法规编纂,并在一般普通法中得到加强。这拥护了一种信托关系,即患者和医生理解并同意患者所要求的自主权程度。平等的医患关系的发展需要时间。在发展医患关系时,没有时间变量的替代方案。尽管在医学的公司模式下,医生面临着在更短的时间内执行更多临床和行政职责的压力,但在考虑知情选择和共同决策时,时间仍然是最关键的变量。视频、小册子和替代医疗保健提供者不能也不应该替代医生的时间。