Search PubMed⌕ Search

SEARCH · Search PubMed

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.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,315 records · Page 73Linked to original sources
PubMed2000

Malpractice risk assessment among different approaches for informed consent.

INTRODUCTION: The standards for obtaining informed consent, set forth by the Hawaii Revised Statutes, establish that it is the physician's duty to disclose what a reasonable person objectively needs to hear in order to make an informed decision. It is the purpose of this study to report the opinions of medical malpractice attorneys to survey their opinion whether full or limited disclosure of alternative treatments in informed consent is viewed as having a lower malpractice risk. METHODS: Hawaii medical malpractice attorneys viewed a compilation of arguments for and against both full and limited disclosure, and completed an opinion survey after reading samples of disclosure statements in two different case scenarios: 1) a pediatric emergency department case involving a febrile child at risk for occult bacteremia, and 2) an obstetrics case involving a woman with a postdate pregnancy. RESULTS: A vast majority of respondents believe that, in general and in the obstetrics case, full disclosure results in less liability. In the pediatrics ED case, 46% chose full disclosure as having less liability, 38% believe that the same liability exists with both full and limited disclosure, and 15% believe that limited disclosure is associated with less liability in this case. CONCLUSIONS: Hawaii attorneys with medical malpractice experience overwhelmingly agree that, in general, full disclosure is associated will less medical legal liability. Full disclosure was also the option selected as associated with less liability by a majority of attorneys in a sample obstetrical case. Opinions were more diverse in the pediatrics ED case. Many attorneys stressed that judging the risk of liability in general is difficult, and should be done on a case by case basis.

Adult↗
PubMed2000

Full amnesty could encourage provider self-disclosure.

The Federal government's current policy toward healthcare providers that voluntarily disclose improprieties has been ineffective because it offers no guarantee of immunity from prosecution. To be successful, a self-disclosure program must offer real incentives to providers to come forward. The government's self-disclosure programs with respect to tax, environmental, and antitrust laws provide models for an effective amnesty program. The success of these three programs, and particularly of the antitrust program, suggests that healthcare providers would be encouraged to come forward and disclose improprieties if, under certain specific conditions, the OIG and DOJ offered a guarantee of full amnesty to the entity and its officers, directors, and employees.

Financial Management, Hospital↗
PubMed2003

Disclosure of cancer diagnosis and prognosis in Northern Tanzania.

Whether to tell patients with cancer about their diagnoses and prognoses is a matter of great debate. While many argue the importance of giving this information to facilitate informed decision-making, others argue that this same information can extinguish hope. Although there is some evidence that disclosure of this information is now commonplace in many Northern and Western settings, there are very few data about this issue from resource-poor nations describing physicians' decision-making regarding whether to disclose this information. Using a combination of ethnographic and other qualitative methods including participant observation, semi-structured interviews, informal interviews, and a review of key documents in Northern Tanzania, we map some of the salient issues in this setting. Like their colleagues in many other parts of the world, Tanzanian physicians often withhold diagnostic and prognostic information from patients. In addition, however, to the cultural arguments often used to justify this practice, issues of treatment availability and patient poverty also influenced the physicians' disclosure practices. Expatriate and Tanzanian physicians practicing in Northern Tanzania often had different approaches to informing patients of their diagnoses and prognoses. Some Tanzanian physicians advocated the use of a "roundabout" approach to disclosure, arguing that it was more reflective of the normal mode of discourse in Tanzania than the more direct approach advocated by many of their expatriate colleagues. Expatriate physicians and some of their Tanzanian colleagues felt that such an indirect approach often left patients confused, or indeed, uninformed.

Cost of Illness↗
PubMed2002

The new JCAHO patient safety standards and the disclosure of unanticipated outcomes. Joint Commission on Accreditation of Healthcare Organizations.

This article looks at the newly-issued JCAHO standards and their increased focus on patient safety in performance standards for healthcare organizations. As part of these standards, hospitals are required to inform patients of outcomes of care, including unanticipated outcomes. This article examines this requirement and suggests varying interpretations of it. After looking at the current legal and ethical standards requiring disclosure of errors or negligent acts, the article suggests that hospitals are faced with many difficulties in implementing the standard. Specifically, the article argues that more details are necessary regarding what events must be reported and what hospitals are required to do when members of the medical staff refuse to inform patients of medical error.

Accreditation↗
PubMed2000

Bioethics. Helsinki's new clinical rules: fewer placebos, more disclosure.

After 3 years of intense debate, medical researchers and ethicists have agreed on international standards that would dramatically tighten the rules for clinical research and put new limitations on the risks to which patients may be exposed. Meeting in Edinburgh, U.K., on 7 October, the general assembly of the World Medical Association voted to approve a revised version of the 1964 Declaration of Helsinki, the cornerstone of clinical research ethics, that reduces ambiguity in existing guidelines and could force changes in the design of future drug trials.

Bioethics↗
PubMed2004

Misattributed paternity in a living related donor: to disclose or not to disclose?

Many ethical considerations surround living kidney donation, some of which are not anticipated. We present a case in which misattributed paternity was inadvertently discovered during the workup of a father and son and present arguments for and against disclosure of this information. We recommend that transplant programs advise patients participating in living organ donor programs that misattributed paternity might be discovered during routine preoperative testing and that protocols for dealing with complex ethical issues be in place.

Adult↗
PubMed2004

Always having to say you're sorry: an ethical response to making mistakes in professional practice.

Efforts to decrease errors in health care are directed at prevention rather than at managing a situation when a mistake has occurred. Consequently, nurses and other health care providers may not know how to respond properly and may lack sufficient support to make a healthy recovery from the mental anguish and emotional suffering that often accompany making mistakes. This article explores the conceptualization of mistakes and the ethical response to making a mistake. There are three parts to an ethical response to error: disclosure, apology and amends. Honesty and humility are discussed as important virtues that facilitate coping and personal growth for the health care provider who is involved in mistakes. In conclusion, a healthy view of nursing practice and mistake making is one that prevents error but, when prevention is not possible, accepts fallibility as part of the human condition and achieves the best possible outcome for all.

Clinical Competence↗
PubMed1995

Informed consent and disclosure in the physician-patient relationship: expanding obligations for physicians in the United States.

In recent years, the doctrine of informed consent has been one of the primary vehicles by which American courts and legislatures have evaluated the nature and scope of information that physicians must disclose to patients in a variety of treatment situations. Historically, physicians have had the primary responsibility to disclose to patients the nature of a proposed course of treatment, material risks and benefits, as well as reasonably available alternatives, in obtaining consent to treatment. Statutory and common-law developments in the United States appear to suggest that disclosure obligations of physicians in this context are continuing to evolve. This article examines recent judicial and legislative developments in the United States, which appear to underlie expanding disclosure obligations in a variety of situations that arise within the context of the physician-patient relationship. Emphasis is placed on disclosure obligations with respect to the physician's physical condition and its impact on the provision of medical care, information regarding the physician's general ability to perform certain surgeries or other medical procedures, as well as disclosure of research interests, financial interests, and other incentives that may bear upon clinical decision making. This article concludes that physicians should be aware of recent statutory and common-law developments in the United States that may give rise to heightened potential for legal accountability arising out of failure to disclose an increasingly diverse array of information to patients in the physician-patient relationship.

Conflict of Interest↗
PubMed2000

Reasons given for disclosure of maternal HIV status to children.

The purpose of this investigation was to ascertain the reasons given by mothers diagnosed with AIDS (acquired immunodeficiency syndrome) for disclosing or not disclosing their HIV (human immunodeficiency virus) status to their children, a dilemma faced by most HIV-infected parents and those who counsel them. We interviewed 29 mothers residing in one of two New York City facilities that provide housing and medical treatment for adults with AIDS. The majority of these mothers do not live with their children, but all had recent face-to-face contact with them. The two reasons most frequently considered important for disclosing to children were that disclosure was the "right thing to do" and the need to make arrangements for children's future in case of maternal death or incapacity. The reason most frequently considered important for not disclosing was maternal concern about discussing death and dying with children. These findings have significant implications for counseling of HIV-positive parents.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

End-of-life ethical issues in Japan.

This article discusses the end-of-life ethical issues of disclosure of information to the terminally ill patient, informed consent, and overtreatment for the elderly people of Japan. These issues are placed within the cultural context of Japan, which is discussing and developing ways to deal with them. The ethical problems that nurses confront when they work clinically with elderly patients also are outlined. No consensus has been reached about the ethics of health care in Japan.

Aged↗
PubMedDate not supplied

The past suppression of industry knowledge of the toxicity of benzene to humans and potential bias in future benzene research.

Petrochemical industry representatives often withhold information and misinterpret positive evidence of toxicity of benzene, even from their own research, also discouraging or delaying disclosure of findings of adverse effects to the public. They now appear to be attempting to influence study results in industry's favor by offering predetermined conclusions about study results as part of an effort to draw financial support for the studies. The American Petroleum Institute is currently raising funds for benzene research being conducted in China for which it has already announced the intended conclusions.

Animals↗
PubMed2005

The nature of relative subjectivity: a reflexive mode of thought.

Ethical principles including autonomy, justice and equality function in the same paradigm of thought, that is, logocentrism--an epistemological predilection that relies on the analytic power of deciphering between binary oppositions. By studying observable behavior with an analytical approach, however, one immediately limits any recognition and possible understanding of modes of thought based on separate epistemologies. This article seeks to reveal an epistemological predilection that diverges from logocentrism yet continues to function as a fundamental component of ethical behavior. The issue of cancer disclosure in Japan is used to exemplify the nature of relative subjectivity (kankeiteki-shukansei), a term I define and believe to be an epistemological predisposition fundamental to ethical behavior. Relative subjectivity denotes an epistemology quintessential to the behavior of individuals who attend to the respective tides of each particular situation, each interpersonal relationship or, in the context of clinical medicine, to the needs and values of each patient.

Ethics, Clinical↗
PubMed1991

Informing schools about children's chronic illnesses: parents' opinions.

Parents of 217 chronically ill children and adolescents were surveyed concerning their opinions about disclosing medical information to schools. The sample consisted of parents of more than one third of the children and adolescents meeting inclusion criteria who were seen at a university-based pediatric clinic during a 10-week period. Parents were asked (1) whether schools need information about 16 health items, (2) who in the school should know, and (3) who should provide this information. Parents' willingness to disclose information was compared with family and child demographic data. Parents strongly believed that (1) teachers need to be informed and (2) parents should be the primary informers. The consensus that schools need information did not vary with family and child demographics. However, parents of children with poor illness prognosis, greater likelihood of emergencies, and visible illnesses were more supportive of disclosure. Most parents indicated that physicians should provide information on 10 of the 16 items. Physicians were viewed as particularly appropriate informers about recognizing emergencies and medication effects. Only 21% of the parents were aware of any prior contact between the medical care giver and the school concerning their child's illness. Thus, parents want schools informed and believe physicians should be involved in providing information.

Adolescent↗
PubMed2005

Disclosure patterns of eating and weight concerns to clinicians, educational professionals, family, and peers.

OBJECTIVE: The current study investigated disclosure of eating and weight concerns to professionals, peers, and family. METHOD: Responses to a telephone questionnaire probing disclosure patterns were analyzed in a sample of 216 adult subjects with eating or weight symptoms, concerns, or problems. RESULTS: Nearly all of the sample (97.7%) had disclosed information about eating or weight symptoms or concerns to someone. Only 57% of the sample had disclosed this information to a health care professional. However, among subjects who had not otherwise volunteered information about their concerns, those who were queried were more likely than not to disclose them to health care professionals, counselors, and coaches. Disclosure to a health care professional or school counselor was associated with a higher likelihood of subsequent treatment seeking. DISCUSSION: These data suggest that individuals with disordered eating may be quite amenable to disclosing symptoms in clinical settings. Asking about an eating disorder may enhance detection and facilitate treatment in clinical settings.

Adolescent↗
PubMedDate not supplied

Medical students' attitudes towards breaking bad news: an empirical test of the World Health Organization model.

The literature regarding breaking bad news distinguishes three disclosure models: non-disclosure, full-disclosure and individualized disclosure. In this study, we investigated the relations between attitudes regarding disclosure of bad news and global professional attitudes regarding medical care in a sample of medical students (n=88). The Attitudes towards Breaking Bad News Questionnaire was developed and factor analysed to provide a valid and reliable instrument to measure attitudes regarding disclosure of bad news. The results indicate a preference for an individualized, patient-centred disclosure model in male and female students. Regarding the global professional attitudes, female students appear more humane-oriented than male students. Second, the relationship between global professional attitudes and attitudes regarding breaking bad news was examined by means of correlational and cluster analysis. The inter-relationship between global professional attitudes and attitudes regarding bad news is poor. Results of the cluster analysis, however, suggest that the sample can be divided into subsamples representing different disclosure clusters on the basis of specific combinations of global professional attitudes regarding medical care and attitudes regarding breaking bad news. The results are discussed in view of the theoretical framework proposed by the World Health Organization (WHO) in their training module on communication of bad news.

Attitude of Health Personnel↗
PubMed2001

Examining child sexual abuse evaluations: the types of information affecting expert judgment.

OBJECTIVE: There were two aims: First, to determine to what extent four variables, disclosure, doll play, affect and collateral information, affect the decision-making processes of child sexual abuse experts and lay persons when confronted with an abuse allegation, and second, to see how these two groups of raters might differ from one another. METHOD: A randomized block partially confounded factorial design was used. Participants made abuse likelihood and confidence ratings in response to six hypothetical cases of child sexual abuse, four of which had varying combinations of the four types of information and two of which were constant across all raters. Participants also completed attitudes and knowledge questionnaires. RESULTS: Disclosure and collateral information both had large effects on both rater groups. Doll play and affect had little or no effect on the decisions of either group. Experts were slightly more conservative in their judgments over all than students were. Experts also displayed more knowledge of the sexual abuse literature and more child-believing attitudes than their student counterparts. CONCLUSION: Concrete information such as disclosure statements and collateral information affected abuse decisions while inferential data such as doll play and affect did not. The goal of these evaluations may be the clarification of such concrete information and the inferential data may be used only to guide one's inquiry. This conclusion argues against the concern that experts might jump to conclusions of abuse merely based upon suggestive, symbolic material.

Adult↗