Abstract
Objectives: To summarise the types of case brought to the Clinical Ethics Committee of the National Hospital of Norway from 1996 to 2002 and to describe and discuss to what extent issues of information/communication have been involved in the ethical problems.
Design: Systematic review of case reports.
Findings: Of the 31 case discussions, (20 prospective, 11 retrospective), 19 cases concerned treatment of children. Twenty cases concerned ethical problems related to withholding/withdrawing of treatment. In 25 cases aspects of information/communication were involved in the ethical problem, either explicitly (n = 3) or implicitly (n = 22).
Conclusion: Problems related to information/communication may underlie a classic ethical problem. Identification of these "hidden" problems may be important for the analysis, and hence, the solution to the ethical dilemma.
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Selected References
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- Akre V., Falkum E., Hoftvedt B. O., Aasland O. G. The communication atmosphere between physician colleagues: competitive perfectionism or supportive dialogue? A Norwegian study. Soc Sci Med. 1997 Feb;44(4):519–526. doi: 10.1016/s0277-9536(96)00178-5. [DOI] [PubMed] [Google Scholar]
- Coulter A., Entwistle V., Gilbert D. Sharing decisions with patients: is the information good enough? BMJ. 1999 Jan 30;318(7179):318–322. doi: 10.1136/bmj.318.7179.318. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Degner L. F., Kristjanson L. J., Bowman D., Sloan J. A., Carriere K. C., O'Neil J., Bilodeau B., Watson P., Mueller B. Information needs and decisional preferences in women with breast cancer. JAMA. 1997 May 14;277(18):1485–1492. [PubMed] [Google Scholar]
- Dobson Roger. Dulcet tones of a surgeon's voice may have a hidden meaning. BMJ. 2002 Aug 10;325(7359):297–297. doi: 10.1136/bmj.325.7359.297/a. [DOI] [PMC free article] [PubMed] [Google Scholar]
- DuVal G., Sartorius L., Clarridge B., Gensler G., Danis M. What triggers requests for ethics consultations? J Med Ethics. 2001 Apr;27 (Suppl 1):i24–i29. doi: 10.1136/jme.27.suppl_1.i24. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Elger Bernice S., Harding T. W. Should cancer patients be informed about their diagnosis and prognosis? Future doctors and lawyers differ. J Med Ethics. 2002 Aug;28(4):258–265. doi: 10.1136/jme.28.4.258. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Katz J. Why doctors don't disclose uncertainty. Hastings Cent Rep. 1984 Feb;14(1):35–44. [PubMed] [Google Scholar]
- McClung J. A., Kamer R. S., DeLuca M., Barber H. J. Evaluation of a medical ethics consultation service: opinions of patients and health care providers. Am J Med. 1996 Apr;100(4):456–460. doi: 10.1016/S0002-9343(97)89523-X. [DOI] [PubMed] [Google Scholar]
- Robinson A., Thomson R. Variability in patient preferences for participating in medical decision making: implication for the use of decision support tools. Qual Health Care. 2001 Sep;10 (Suppl 1):i34–i38. doi: 10.1136/qhc.0100034... [DOI] [PMC free article] [PubMed] [Google Scholar]
- Siegler M., Singer P. A. Clinical ethics consultation: Godsend or "God squad"? Am J Med. 1988 Dec;85(6):759–760. doi: 10.1016/s0002-9343(88)80016-0. [DOI] [PubMed] [Google Scholar]
- Way Jenny, Back Anthony L., Curtis J. Randall. Withdrawing life support and resolution of conflict with families. BMJ. 2002 Dec 7;325(7376):1342–1345. doi: 10.1136/bmj.325.7376.1342. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wu A. W. Medical error: the second victim. The doctor who makes the mistake needs help too. BMJ. 2000 Mar 18;320(7237):726–727. doi: 10.1136/bmj.320.7237.726. [DOI] [PMC free article] [PubMed] [Google Scholar]