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Results for “Third-Party Consent”

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At least 19 recordsLinked to original sources
PubMed1982

Third-party consent to medical procedures.

The issue of consent to medical procedures is a particularly complex one when the patient is incapable of giving valid consent (because of age, mental disability, or physical state). A medical practitioner who proceeds with treatment without valid consent may be liable to legal action or disciplinary proceedings. Third-party consent can be given by parents legally appointed guardians. Consent is not required if emergency treatment is necessary to preserve the life of the patient. It is extremely doubtful whether valid third-party consent can be given for procedures which are not essential for the preservation of life or health.

Australia↗
PubMed2025

"It just feels morally not right to Sell the data": Ethical and social perspectives on human genomic data sharing in Uganda-A phenomenological qualitative study.

While genomic data sharing enhances transparency and research efficiency, it also raises significant ethical and social challenges. This study explored stakeholders' perspectives on these issues, particularly around privacy, confidentiality, and equity in collaborative research. A phenomenological qualitative study was conducted between August and December 2023 at Makerere University College of Health Sciences, other research-intensive institutions, and national regulatory bodies. The study engaged 86 participants: 47 key informants (16 researchers, 14 ethics committee members, nine community advisory board members, and eight research regulators) and four deliberative focus group discussions with 39 participants. Interviews were transcribed verbatim, and thematic analysis was conducted using NVivo 14. Three major themes emerged: (1) stakeholders' experiences in genomic research, including their roles as participants, implementers, or overseers; (2) ethical concerns, such as informed consent, third-party data access, inequities between high-income and low- and middle-income country (LMIC) researchers and participants, and the lack of benefit-sharing frameworks; and (3) social implications, including stigma, discrimination, labeling, community perceptions of fairness, and the need for meaningful engagement. Participants emphasized the importance of protecting participant rights, promoting equity, and ensuring robust data governance and security. The theoretical frameworks of principlism and distributive justice provided a valuable lens for examining these concerns, particularly by highlighting the need to safeguard privacy and fairly distribute responsibilities and benefits in global collaborations. Participants also noted that perceptions of fairness are shaped by trust, local context, and past experiences with research factors that are critical for building equitable and respectful partnerships. This study underscores the urgent need to strengthen protections for research participants and promote fairness in genomic data sharing. Policies should, if adopted, emphasize culturally contextualized consent, active community engagement, restricted third-party data access, and strong data protection mechanisms to address existing inequities and prevent misuse.

LMICs↗
PubMed1987

Public policy issues relevant to children of alcoholics.

A brief overview of current interest in public policy related to alcohol problems is presented. Issues having special relevance to children of alcoholics are discussed, including: prevention (identification of subjects at risk, public recommendations about drinking and pregnancy, child abuse and neglect); treatment (reaching treatment professionals, parental consent, confidentiality, third-party coverage, early intervention), and research.

Adult↗
PubMed1991

The case of the wrong tooth.

As can be seen from this report, multifactorial considerations are often present in an orthodontic case. Office policy considerations regarding interoffice communications should be reviewed periodically as to their sufficiency. Interpersonal communications are vitally important from both a risk management standpoint and also from the perspective of maintaining a good doctor-patient relationship. Practitioners today need to keep a wary eye open regarding all possible treatment alternatives, even bizarre ones, should the clinical situation dictate the need for them. Good recordkeeping and documentation are omnipotent should one have the need to defend one's actions. This applies not only to radiographs, photographs, and treatment charts but to records of third-party conversations as well. The doctrine of informed consent should act as a guideline to what information need be transmitted to the patient, both at the beginning and throughout treatment, as it can often help calm potentially troubled waters. Finally, a little luck never hurt anybody.

Adult↗
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↗
PubMed1990

Attorney/physician. Guidelines for inter-professional conduct.

It has come to our attention that many attorneys are causing record copy companies to subpoena medical records without attaching an authorization or consent signed by the patient. This is unacceptable. Physicians should never honor a third-party request or subpoena for records without a properly executed authorization signed by the patient. The power of a subpoena should never be used to put a physician in the position of violating patient confidentiality through lack of understanding or intimidation. The attorney should be responsible to see that a proper authorization is submitted with the records request or subpoena. A physician who receives a records request or subpoena without such an authorization should immediately communicate refusal to comply and the reason to the initiating attorney. The medical and legal professions have established an attorney/physician code covering this and related issues. The code is set forth verbatim.

Expert Testimony↗
PubMed1992

Reducing unnecessary psychiatric consultations for informed consent by liaison with administration.

The frequency of a psychiatric consultation being requested to assess a patients' capacity to give informed consent varies among institutions, with most recent surveys reporting a frequency of between 3% and 8% of all consultations. At Montefiore Medical Center, a hospital policy was interpreted as mandating such consultations for all patients with possible or even definite lack of decisional capacity. From 1987 to 1988, 55% of all psychiatric consultations in the institution were for consent. Only 9% of the consent patients seen had an Axis I diagnosis other than organic mental syndrome (OMS). Because many of these consultations were believed to be unnecessary, with patient clearly able or unable to give consent, the consultation service worked first with administration to modify the guidelines, and then educated the medical and nursing staff as to when consultation was indicated. With this program, the number of consent consultations fell from 958 in 1988 to 177 in 1990, representing a major saving of staff time and third-party billings. In this era of cost containment and outside review of professional practices, psychiatrists must take responsibility for identifying areas where patient services and billings for them are not justified by clinical indications.

Aged↗
PubMedDate not supplied

Informed consent: an ethical dilemma.

Health care today involves complex decisions. How these decisions are made and by whom are the concerns of consumers, healthcare providers, ethicists, third-party payers, and the legal community. The authors explore the question of whether hospitalized clients participate in informed decision making and they use a case study to demonstrate application of Curtin's model for ethical decision making.

Aged↗
PubMedDate not supplied

Medical malpractice: a case study in medical and legal decision making.

The conference was organized in part to dispel some of the misinformation that interferes with cooperative efforts of attorneys and physicians to redress the malpractice situation. During discussion of the hypothetical case, participants identified how medical decision-making responsibilities were allocated among health care providers caring for the patient. Panel members suggested ways in which medical decision making might be affected by non-medical factors such as third-party reimbursement (e.g., selection of inpatient or outpatient setting, the opportunity to discuss issues related to informed consent prior to the day of a procedure) and potential malpractice litigation (e.g., documentation in charts, use of diagnostic procedures). The characterization of decision-making roles and responsibilities differed somewhat for purposes of malpractice litigation; that is, which caregivers might be named as defendants. Panel members reconstructed the development of the medical incident into a legal case. Plaintiff's attorney commented that it is often a hospital employee who advises the family to consult an attorney and described some of the constraints on information gathering (e.g., the rule of "discovery" requiring that suit be filed before defendants can be forced to give statements about what happened, insurance contract provisions prohibiting physicians from talking without legal counsel present to persons who indicate that they plan to file suit). He also briefly explained the rationale for the contingency fee arrangement in these cases. Describing the role of the medical expert witness and the need to review the medical record, he outlined the process of deciding whether to pursue a malpractice case. In making this decision, plaintiff's attorney evaluates the facts to identify issues in the case, to determine if there are deviations from the standard of care, and to try to predict jury reaction. If a suit is filed, defense attorneys employed by the hospital, insurance company, or individual defendants will decide, based on facts including coverage limits, possible publicity, and likelihood of successful prosecution, whether the case should be settled and for what amount. Interests represented by the defense attorneys differ and may affect settlement strategies. Physician feelings of concern for the patient/family or desire for vindication will, to varying degrees, be factors in the decision to try or settle a case. Panel members explored several important policy issues. Among these were the effect of malpractice cases on doctor-patient communications and ethical issues concerning expert witnesses.(ABSTRACT TRUNCATED AT 400 WORDS)

Decision Making↗
PubMed1990

Transurethral resection versus transurethral incision of the prostate.

A new operation, transurethral incision of prostate (TUIP), performed on 846 patients in 20 years, is offered primarily for the management of bladder outlet obstruction in young, middle-aged, and those old men with small prostates who otherwise would be subjected for years to dilatation, massage, and drugs with only partial and temporary relief. In matched cases, results and complications are the same for TUIP and TURP except for the troublesome bladder neck contracture and the higher incidence of reflex into the seminal vesicles and sexual complications after resection of the prostate. Transurethral incision is unsuitable for large prostates. As for economics, compassion and wisdom in fee collection are justified. Cost reduction in health care may be necessary, but it hurts everyone involved. There is no such thing as unnecessary surgery when the critics are charged with decision making about the health and life of the patient before surgery. Finally, before the advent of the third-party payment, operations were avoided because of the financial burden. The surgeon, the patient, and the relatives silently consented to no care. This "silent consent" did not improve the quality of life but did contain costs--as well as longevity.

Adult↗
PubMed1991

Management of the violent patient. Therapeutic and legal considerations.

1. Express consent is desirable in caring for patients. However, in an emergency, when the patient is incapable of giving valid consent and harm from failure to treat is potentially imminent, care must be provided. 2. Presentation of a combative patient to an Emergency Department implies a duty of the emergency physician to render assistance according to standards of emergency medical care. 3. Third-party interests must be considered when other patients, coworkers, or potential victims of harm or violence are foreseeably recognized.

Antipsychotic Agents↗
PubMedDate not supplied

Practical guidelines for developing an office-based program for outpatient intravenous therapy.

As early discharge from the hospital and initiation of outpatient iv therapy have become more common, physicians have found that although their role as care giver has not diminished, compensation by insurers for that care has. Therefore, physicians may wish to establish their own office-based programs for providing cost-effective, quality care for patients who can be treated on an outpatient basis. Important factors in the establishment of such a program are obtaining the services of a nurse skilled in administration of iv antibiotics and the services of a cooperative pharmacist, utilizing treatment consent forms and instructive handouts for patients, and providing 7-day-per-week nursing care. Physicians must immediately hospitalize program participants who experience complications. To ensure cooperation from third-party payers, familiarity with their codes for procedural terminology is necessary. It is also highly advisable to obtain written approval for a patient's participation in the program from the medical director or another key official of the insurance company.

Ambulatory Care↗
PubMed1977

The National Commission and research in pharmacology: an overview.

Participation in research of children, prisoners, or those institutionalized as mentally infirm is problematic because it appears to violate one or the other of two fundamental ethical principles: the principle of respect for persons, which requires that subjects give voluntary and informed consent, and the principle of justice, which requires that vulnerable persons not bear burdens in order that others may benefit. The National Commission recommends that conditions of constraint be minimized so that prospective subjects can make truly voluntary choices, that special protections such as third-party permission and national review be brought to bear for non-comprehending subjects, and that vulnerable persons be used only when less vulnerable persons are not suitable subjects or when the research is designed to develop or evaluate therapeutic interventions intended to benefit the individual subject. These recommendations might have the practical effect of restricting certain types of research (e.g., Phase I drug testing), but they are less restrictive than other proposals, and they reflect a conviction that research using special subject populations can be conducted in accord with fundamental ethical principles.

Adult↗
PubMed1986

Ethical considerations in the management of infertility.

Ethical issues arising in the day-to-day practice of infertility treatment are important and sometimes difficult. A couple's infertility problem usually has affective and social dimensions, sometimes disrupting their lives. Responsible care involves dealing with these psychosocial factors, including counseling and striving for informed patient decision making. The ethical problem of whether to provide treatment when the probability of success is low is sometimes complicated by a couple's desperate desire for fertility. In such cases the physician weighs various factors, including the risks of the procedure, the harm that might result from continuing infertility and the degree of the couple's understanding of the pros and cons. Issues of truth telling are raised by a lack of third-party reimbursement for infertility workup and treatment. Also, questions about when to refer or terminate the workup and therapy involve ethical reflection about potential conflicts of interest.

Disclosure↗
PubMed1989

Problems in genetic prediction for Huntington's disease.

Experience with nearly 300 applicants for predictive testing for Huntington's disease has shown that apart from the expected problems such as those related to third-party interests and the effects of an adverse test result, there were several less foreseen difficulties. These included the finding that some applicants were already clinically affected, requests for testing of minors, unintentional risk alteration for relatives, and the use of research samples for service purposes. More of the problems involved clinical and counselling aspects rather than laboratory procedures.

Adolescent↗
PubMed1987

Regulatory and legal aspects of outpatient surgery.

This is a brief summary of the regulatory and other legal issues that may be raised by the provision of surgery outside of the hospital environment. Despite these potential problems, however, outpatient surgery embodies significant potential for hospitals, physicians, patients, and third-party payers. Outpatient surgical facilities embody the potential to achieve two of the government's primary goals: the provision of high-quality services and the reduction of health care costs. Third-party payers, similarly, are increasingly recognizing the benefits of outpatient surgery. Some are providing "facility" payments to cover the overhead costs of such facilities, or at least, providing an add-on to physicians' professional fees, for example, UCR (usual and customary rates) plus 20 per cent, if surgery is conducted in an office setting. Health maintenance organizations and other alternative delivery systems are actively seeking to enter into contracts with ambulatory surgical centers to provide outpatient surgical services to their enrollees because HMOs and other alternative delivery systems maximize profits by decreasing inpatient hospital utilization. In the years ahead, certificate of need and other regulatory barriers to the establishment of ambulatory surgical centers may fall as states increasingly begin to reassess the costs and benefits of certificate of need programs. In short, the trend toward outpatient surgical facilities and outpatient care generally is one that is here to stay.

Ambulatory Surgical Procedures↗