Adolescent medicine: state of the art reviews
-
Adolesc Med State Art Rev · Aug 2011
Treatment of anorexia nervosa against the patient's will: ethical considerations.
By the nature of their illness, many if not most patients with anorexia nervosa are treated against their will. This article explores the issue of patient autonomy and right to treatment refusal in the light of justified paternalism as well as a more enriched understanding of autonomy in the context of relationships. A summary follows on the research on patients' perceptions and response to involuntary treatment. The conclusion addresses the importance of human values intrinsic to the quality of a clinical relationship as determinant for patient recovery and professional satisfaction.
-
This article describes iatrogenic events, giving examples that range from individual error to systemic malfunctions. It then goes on to analyze individual and system responsibilities in the disclosure of iatrogenic events. A discussion follows on the physician's responsibility, professional integrity, "duty to warn", and transparency as they relate to error disclosure, including an examination of the role of apology and repair in the setting of iatrogenesis. It concludes by considering the moral and legal operational implications of iatrogenic events and the building of a culture of safety.