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Results for “Truth Disclosure”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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At least 829 records · Page 46Linked to original sources
PubMed1998

Physicians' perceptions of managed care.

We wished to determine physicians' views and knowledge of managed care, particularly their beliefs about the provisions of managed care contracts in terms of legality and ethics. A questionnaire was sent to the 315 physicians of the medical staff of Norwalk Hospital in Connecticut regarding managed care and managed care contracts. Sixty-six responses were received within a 45-day period (20.9% return). Although only 1 of 11 contract provisions presented in one section of the questionnaire was illegal in Connecticut, a majority of physicians believed 7 of the 11 were illegal. On average, 50% of physicians polled thought each of the provisions was illegal, and a varying majority of physicians (53% to 95.4%) felt the various provisions were unethical. The majority of respondents (84.8% to 92.4%) believed that nondisclosure provisions were unethical. Ninety-seven percent thought managed care interferes with quality of care, and 72.7% of physicians felt that the managed care industry should be held legally responsible for ensuring quality of care. However, 92.4% of physicians considered themselves to be ethically responsible for ensuring quality of care. Physicians have a poor understanding of the legal aspects of managed care contracts but feel strongly that many provisions of these contracts are unethical. Physicians also believe that managed care is causing medicine to be practiced in a manner that is contrary to patients' interests and that legal recourse is needed to prevent this.

Attitude of Health Personnel↗
PubMed1994

Science police.

Explore the source record for details and available documents.

Biomedical Research↗
PubMedDate not supplied

HIV and pregnancy.

Testing women of childbearing age for HIV infection and disclosure of HIV status should be examined from three interlocking perspectives--women's personal concerns, the interests of caregivers, and those of the community. In the absence of specific objections, testing for HIV infection should be considered a routine procedure in prenatal care.

Adolescent↗
PubMedDate not supplied

Informed consent for fertility control services.

Informed consent has special relevance for patients seeking fertility control services who are not ill in the usual sense. Genuine informed consent requirements should not be confused with spurious ones induced by political pressure.

Abortion, Legal↗
PubMed1997

When a physician harms a patient by a medical error: ethical, legal, and risk-management considerations.

Errors that harm patients are infrequently brought to the attention of these patients. The full disclosure of such medical errors is in the best interest of patients because it allows them to understand what has occurred, and to gain appropriate compensation for the harm that they have suffered. Physicians have been given little guidance regarding how to conduct a relationship with the patient after such an injury. We argue that the physician must continue to respect the patient, and communicate honestly with him or her throughout their relationship, even after the patient has been injured. It is painful to admit our errors, especially to those who have been harmed by them. Nevertheless, offering an apology for harming a patient should be considered to be one of the ethical responsibilities of the profession of medicine. Monetary compensation alone is not to be offered as a charitable gesture; rather, it should be accompanied by an apology to demonstrate the responsibility of the physician to the trusting patient. Full and honest disclosure of errors is most consistent with the mutual respect and trust patients expect from their physicians. Clearly, physicians' ethical responsibilities sometimes differ from their legal and risk-management responsibilities.

Adult↗
PubMed2006

Facilitating and impeding factors for physicians' error disclosure: a structured literature review.

BACKGROUND: It is important for physicians to disclose medical errors to institutions (for patient safety), to colleagues (for professional learning), and to patients (as part of direct patient care), but no comprehensive review of factors that may facilitate or impede disclosure has been undertaken. METHODS: A MEDLINE search was conducted of English-language articles published from 1975-2004, with review of bibliographies. A total of 5,509 articles were reviewed by title, 881 articles were retrieved for full text review, and 475 articles satisfied the inclusion criteria. Article content was assessed by identifying factors that facilitate or impede disclosure and classifying each article's primary goal of disclosure. RESULTS: Thirty-five factors believed to facilitate disclosure were identified (for example, accountability, honesty, restitution), as were 41 factors believed to impede it (for example, professional repercussions, legal liability, blame). The three most common goals of disclosure were to improve patient safety, enhance learning, and inform patients. Facilitating factors were more commonly cited when the goal of disclosure was to inform patients. DISCUSSION: A wide range of factors are capable of facilitating or impeding the disclosure of medical errors. Innovations to enhance error disclosure should address both sides of the equation: impeding factors should be removed and facilitating factors should be promoted.

Communication Barriers↗
PubMed2004

Sensitive mother-to-adolescent disclosures after divorce: is the experience of sons different from that of daughters?

This study addressed two main questions: (a) Are adolescent sons and daughters exposed to sensitive maternal disclosures after divorce with similar frequency and in similar detail? and (b) Does gender act as a moderator in the association between maternal disclosures and adolescent adjustment difficulties? Forced-choice and open-ended data were collected from 194 adolescents within 2 years after their parents' divorce. Quantitative analyses revealed that although the majority of adolescents experience some level of maternal disclosure, neither frequency nor detail of maternal disclosure differed as a function of adolescent gender. Frequent and detailed maternal disclosures were associated with adolescent adjustment difficulties, primarily psychological distress. Gender did not moderate that significant association. Qualitative analysis shed light on the link between maternal disclosures and adolescent distress, suggested the importance of how disclosures are made, and revealed several gender differences in reactions to maternal disclosures. Implications of the findings are discussed.

Adolescent↗
PubMed2001

Public release of information on quality of care: how are health services and the public expected to respond?

Public disclosure of the comparative performance of health care providers has been proposed as one mechanism of improving the quality of care. Performance data have been made public in the USA for over a decade and the provision of comparative information about quality of care is a central feature of current UK government health policy. The balance between the advantages and risks of pursuing such a policy in publicly funded health service is largely unknown. Advocates of public disclosure cite the role that comparative data can play in ensuring accountability, shifting the ownership of information (and therefore power) from professionals to service users and encouraging improvements in the processes and outcomes of care. However, these expectations are not necessarily realistic. There is some evidence that the public make little use of comparative data and there is a risk that public release may result in a loss of confidence in the health system and demoralisation of health service staff. In addition, there is a legitimate doubt that any early impact of disclosure will not be sustained and that the outcomes will not justify the necessary expenditure. In conclusion, we suggest that the theoretical benefits of promoting public disclosure as voiced by advocates of the policy may not be realised in practice.

Health Services Research↗
PubMed2001

Hope and harm: a delicate balance. Death and dying in multicultural Australia.

Australia's cultural diversity poses challenges to healthcare professionals, particularly in caring for dying people. Different cultures have different attitudes to the role of the doctor, patient autonomy and disclosure of diagnosis and prognosis. Doctors need to recognise the cultural and spiritual needs of patients and their families.

Attitude to Death↗
PubMed1989

AIDS: how to protect your lab on legal issues.

Here's the evolving law on such matters as transfusion-transmitted AIDS, false positives and negatives, disclosure of test results, protection of the health care staff, and employees who refuse to work with AIDS patients.

AIDS Serodiagnosis↗
PubMed1989

What HMOs should tell their subscribers, and what you can do about it.

All health maintenance organization (HMO) plans try to control costs by restricting choice of physicians and regulating utilization of service. Have some plans gone too far? Patient and physician can become caught in a complex web of gatekeepers and capitation arrangements, withholds, bonuses, and penalties. Patients are almost always unaware of the details of these pressures on the physician. For the free market system to operate, potential subscribers should receive all of the facts about their HMOs. This article offers practical suggestions for concerned physicians, including information about proposals for legislative requirements of disclosure statements and a list of questions patients should ask before joining an HMO.

Economic Competition↗
PubMed1999

FASB Statement No. 132 simplifies benefits disclosures.

In February 1998, the FASB issued Statement of Financial Accounting Standards No. 132, Employers' Disclosures about Pensions and Other Postretirement Benefits. The new standard is designed to streamline pension and other postretirement benefits disclosures in public and nonpublic entities' financial statements. For nonpublic entities, the statement eliminates separate disclosures of the components of net periodic benefit cost, eliminates the disclosure of the components of benefit obligations and of alternative obligation measures, eliminates the disclosure of plan provisions, adds the disclosure of comprehensive income, eliminates the disclosure of sensitivity to changes in healthcare trend rates, and standardizes the disclosures for pension and other postretirement benefits. Financial managers and their organizations' actuaries and auditors should work together to determine which disclosures their organizations should make to be in compliance with FASB Statement No. 132.

Accounting↗
PubMed2002

Unanticipated consequences of unanticipated outcomes disclosures.

This article discusses the complex legal and operational issues related to the Joint Commission on Accreditation of Healthcare Organizations' (JCAHO) unanticipated outcomes disclosure standard. The author examines case law on the discoverability of hospital quality improvement efforts and information submitted to the JCAHO, and considers whether submitting this information to JCAHO amounts to a waiver of privilege. The author concludes disclosure of an unanticipated outcome should not give rise to a waiver if the hospital and physician are careful in making the disclosure.

Accreditation↗
PubMedDate not supplied

How children tell: the process of disclosure in child sexual abuse.

In an analysis of the disclosure by a large number of children from three to 17 years of age of having been sexually abused, and who were eventually confirmed as credible victims, the large majority at first denied the abuse. The authors describe disclosure as a process with definable phases and characteristics--seldom the single entity that typical investigations consider disclosure to be, thereby setting the stage for ensuring injustices and harm to the children.

Adolescent↗
PubMed1986

Physician management of patients with adverse outcomes.

The incidence of iatrogenic complications of medical or surgical care is increasing. Such adverse events may severely strain the patient/physician relationship. The nature of the underlying patient/physician relationship in terms of the style of interaction and the handling of uncertainty and decision making may influence the impact of adverse events on the relationship. Physicians may manage these situations poorly because of perceived threats to their self-image or sense of control, or because of fear of malpractice suits. Patients may consciously or subconsciously blame the physician, fall to express their concerns, or exaggerate their complaints. If possible, continuity of the patient/physician relationship should be maintained through full disclosure of all medical facts, frank and open communication, and a renewed commitment to the therapeutic relationship.

Communication↗