1. Current Legal and Ethical
Controversies in American
Health Care
Informed Consent and Shared
Decision Making
2. FSU COLLEGE OF MEDICINE
Instructors
Marshall B. Kapp, J.D. M.P.H.
Gregory Todd, J.D., M.D.
– Associate Professor, College of Medicine
– Program Director, FSU Internal
Medicine Residency Program
3. FSU COLLEGE OF MEDICINE
Why Informed Consent and
Shared Decision Making?
Autonomy/Self-Determination
Beneficence
4. FSU COLLEGE OF MEDICINE
Elements of Informed Consent
Voluntary
Competent decision maker
Informed
5. FSU COLLEGE OF MEDICINE
What Information Do You
Want?
Nature of the problem
Recommended plan
Prognosis, with or without intervention
Reasonable alternatives (always including
doing nothing)
Risks of recommended plan and
alternatives
Patient’s responsibilities and limitations
Financial considerations?
Other?
6. FSU COLLEGE OF MEDICINE
Consent Forms
Purpose/Effect
– Document that the process of
communication took place
– Protect the health care provider
Does not take the place of proper
communication.
Does create a presumption that proper
communication took place, shifts burden to
patient to prove that communication
process was inadequate.
7. FSU COLLEGE OF MEDICINE
Case Discussions
Mr. B, 75-year old man in generally
good health
– Should physician recommend PSA
screening? Should the patient
consent?
8. FSU COLLEGE OF MEDICINE
Ms. A, 45-year old woman in good
health, no family history of breast
cancer
– Should physician recommend a
screening mammography? Should the
patient consent?
9. FSU COLLEGE OF MEDICINE
Ms. C is a 60-year-old, post-
menopausal woman with no serious
health problems and no significant
family history of cardiovascular
problems.
– Should her physician recommend
hormone replacement therapy?
– Should Ms. C consent?
10. FSU COLLEGE OF MEDICINE
Shared Decision Making
https://www.youtube.com/watch?v=XPm5iEDEI
8Y&list=PL92C4D5A6B4CD339E
https://www.youtube.com/watch?v=5kXso8aPV
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https://www.youtube.com/watch?v=6pUeUIwQ6
so&index=13&list=PLB7F6CFCD9AFD5F47
