The Medical clinics of North America
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Med. Clin. North Am. · Jul 2022
ReviewThe Role of Informed Consent in Clinical and Research Settings.
Informed consent plays an integral role in governing the patient-physician relationship with origins traced back to ancient Greek philosophy. The main pillars of informed consent are autonomy, integrity, respect, and care. ⋯ Understanding the process of informed consent is critical for patients, researchers, and medical practitioners. In this article, the authors provide a brief historical narrative of informed consent, elaborate on the process of obtaining an ethically and legally valid informed consent, and present some of the future challenges in the field.
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The diagnostic medical interview spans from the chief concern to the formation of a differential diagnosis. The patient's unique expression of their symptoms is the central component of this conversation. ⋯ Performing a comprehensive medical interview by obtaining background health information and the review of systems can help to expand or shrink the differential diagnosis. Clinicians should obtain information about specific symptoms and background information with a significant likelihood to narrow the differential diagnosis.
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Difficult patient encounters are common in clinical practice, with many arising from patient hostility owing to a breakdown in communication and the health care alliance. Patient anger may be a manifestation of fear, grief, or discontent with prior experiences in the health care system, but there may also be contributions from specific patient, physician, or situational factors. Physicians may intervene with specific actions based on these individual factors, while focusing on self-reflection to better understand their part in creating a hostile physician-patient dyad.