Patient autonomy in emergency medicine |
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Authors: | Naess Anne-Cathrine Foerde Reidun Steen Petter Andreas |
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Affiliation: | (1) Centre for Medical Ethics, School of Medicine, University of Oslo, Pb. 1130 Blindern, N-0317 Oslo, Norway;(2) Division of Surgery, Ulleval University Hospital and University of Oslo, N-0407 Oslo, Norway |
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Abstract: | Theoretical models for patient-physician communication in clinical practice are frequently described in the literature. Respecting patient autonomy is an ethical problem the physician faces in a medical emergency situation. No theoretical physician-patient model seems to be ideal for solving the communication problem in clinical practice. Theoretical models can at best give guidance to behavior and judgement in emergency situations. In this article the premises of autonomous treatment decisions are discussed. Based on a case-report we discuss different genuine efforts the physician can do to uncover treatment refusal and respect patient autonomy in an emergency situation. Autonomy requires competence and in emergency medicine time does not allow intimate exploration of patient competence and reasons for treatment refusal. We find that the physician must base her decision on a firm theoretical base combined with a practical and realistic view of the patient's situation on a case to case basis.This revised version was published online in October 2005 with corrections to the Cover Date. |
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Keywords: | ethics mental competence physician integrity physician-patient relationship respect for autonomy treatment refusal |
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