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Biomedical subjects

M B Kapp

Publications and source records attributed to M B Kapp.

At least 91 records · Page 5Linked to original sources
PubMed1989

Enforcing patient preferences. Linking payment for medical care to informed consent.

The legal and ethical doctrine of informed consent is well accepted in modern medicine. Nonetheless, medical interventions sometimes take place in the absence of informed consent, particularly in the case of life-sustaining medical procedures. These procedures ordinarily are reimbursed by third-party payers. This article proposes as a strategy to ensure greater attention to patient preferences in medical decision making that financial reimbursement for each medical service be linked to a requirement of valid patient (or surrogate) consent to the service involved. Utilization review bodies could monitor informed consent in the same way that other aspects of necessity, appropriateness, and quality are now monitored.

Consent Forms↗
PubMed1989

The malpractice crisis. Relevance for geriatrics.

The adverse effects of the current American medical malpractice problem on the practice of geriatric medicine have thus far been relatively minor, but real. This article discusses some of the prominent public policy issues involved in the ongoing debate about malpractice, with special application to older patients and their physicians. Suggestions are made for appropriate actions by geriatricians individually and collectively, in response to the malpractice situation.

Age Factors↗
PubMed1989

Informed consent for federal clinicians.

The principle of informed consent to medical care is by now well recognized but incompletely understood and implemented. This article discusses the ethical and legal foundations of the informed consent doctrine, the relevance of informed consent for health care providers employed by the federal government, the elements of valid consent, the concept of state substantive law as governing, different information disclosure standards, disclosure elements, exceptions to the consent requirement, and the proper documentation of consent.

Consent Forms↗
PubMed1989

Advocacy for the mentally impaired elderly: a case study analysis.

The authors present a case study to illustrate how a mentally impaired but socially intact nursing home resident, who had no one to act as an advocate for her, was denied appropriate treatment for an acute illness which ultimately resulted in her death. The case raises important questions about advocacy for the mentally-impaired, acutely-ill institutionalized patient. This Article explores the role of the advocate, how advocates are selected, what qualities and talents they should possess, and what responsibilities should be assigned to them. The authors suggest that nursing home residents should be encouraged to engage in self-advocacy to the greatest extent possible. The competent elderly should be urged to name their preferred advocates. Individuals who serve in advocacy roles should be advised to seek information regarding the patient's wishes from those who know the patient well. Furthermore, there is a need for quality education and training of those who serve in advocacy roles on behalf of nursing home residents, and state laws need to specify the responsibilities of persons who serve as advocates.

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PubMed1988

Advance health care planning: taking a "medical future".

This article describes the living will and durable power of attorney as legal mechanisms for advance health care planning, and discusses the role of the physician in health care planning. The concept of a "medical future" is a new but not radically different device for furthering the objectives of advance health care planning.

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PubMed1988

Forcing services on at-risk older adults: when doing good is not so good.

This essay examines the interplay between the ethical principles of autonomy and beneficence in the context of deciding whether to intervene in the life of an at-risk older adult by providing health and human services over the older person's objection. The need to distinguish between the rights and welfare of the older client, on one hand, and the interests and drives of the professional caregiver, on the other hand, is emphasized.

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PubMed1988

Health care delivery and the elderly: teaching old patients new tricks.

The author examines the revolutionary changes currently altering the delivery of health care in America: competition, corporatization, reprivatization, and cost containment. The changes portend a bleak future for elderly citizens, inevitably leading to inequities in access to high quality health care for this uniquely vulnerable group. Focusing on health care financing driven by a DRG system, the author raises ethical, economic nd legal issues which must be addressed by a responsible society. Finally, the author contrasts the traditional legal response to the elderly for protection of their right to equitable access to high quality health care and recommends changes to ensure fuller protection for elderly citizens.

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PubMed1988

Decision making by and for nursing home residents. A legal view.

The law is concerned with a panoply of issues affecting the care and lives of nursing home residents. This article has outlined one area, that of decision making, which in many respects is the embodiment of and key to all other fundamental resident rights. The doctrine of informed consent applies with full force in the nursing home, both for mentally competent residents and for cognitively impaired residents for whom decision making rights must be exercised through a proxy. Long-term care institutions and professionals are obligated to insure that decisions made by or for residents are made voluntarily, competently, and knowingly.

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