ethics of withholding information

Some studies may not directly deceive the participant but will withhold some information, such as the reason why a participant was selected for the study. Although clinical trials are not always designed to benefit study subjects, health care professionals (and clinical researchers) have an obligation to future patients. There are many physicians who worry about the harmful effects of disclosing too much information to patients. If you have questions, concerns, suggestions about research, a research-related injury or questions about the rights of a research participant, you may contact the Office of the Vice President for Research (VPR) at vpresearch@virginia.edu. Truthful and open communication between physician and patient is essential for trust in the relationship and for respect for autonomy. Massimo Reichlin in On the ethics of withholding and withdrawing medical treatment investigates precisely this concept . The people and events in this case are fictional. Her family approaches the physician and asks that the patient not be told, stating that in her upbringing in mainland China tuberculosis was considered fatal and to tell her would be like giving her "a death sentence.". INFORMATION DISCLOSURE, ETHICAL ISSUES OF Since 1970, ethically recommended healthcare practice in the United States has increasingly supported a high level of information disclosure to patients. ( Despite these shortcomings, there might be many legitimate reasons why a physician might suggest that a patient participate in a clinical trial. Many journalists agree to withhold information that could give away imminent police and military operations. withholding the information from the person who is deceived, and that the reasonableness of withholding information is dependent on the context. A written debriefing statement should always use non-technical language and provide participants with a clear sense of the main question and the importance of the answer. The guiding principle is that the lawyer should fulfill reasonable client expectations for information consistent with the duty to act in the client's best interests, and the client's overall requirements as to the character of representation. However, there may be legitimate reasons to withhold information. NEW! Clinical trials are research experiments designed to test the safety and/or efficacy of an unproven treatment. Now that the participant understands the full scope of the study, the participant has the opportunity to decide whether he or she wants to include their data in the study. Hence it is important to invoke this only in those instances when the harm seems very likely, not merely hypothetical. Adjunctprofessor, Medical History and Ethics, When physicians communicate with patients, being honest is an important way to foster trust and show respect for the patient. It is important that you do not let this incident become an issue in your relationship. A placebo is any substance given to a patient with the knowledge that it has no specific clinical effect, yet with the suggestion to the patient that it will provide some benefit. A lawyer may not withhold information to serve the lawyer's own interest or convenience or the interests or convenience of another person. Some patients might ask that the physician instead consult family members, for instance. ( If he finds that the patient does hold such beliefs about the harmful nature of truthful disclosure of the truth, then it would be justifiable to withhold the diagnosis of tuberculosis. Five Standards For Significant Choice; Problems of Misinformation; Challenge of Information Uncertainty in Crises; Communication Ambiguity in Crises; Acknowledge Uncertainty and Ambiguity; Ethics Of Withholding Information This course has many interactive elements that don't work well on Internet Explorer or older versions of Firefox. In certain situations and with special safeguards, it can be appropriate to provide experimental treatment without a participants informed consent. You will give the participant apost-deception consent form. To resolve these questions, we must briefly re-examine the purpose of clinical trials. It describes a layoff situation in which a manager has the latitude to decide what information to release and when, lists the reasons managers commonly give for withholding You should not withhold information a patient needs to make a decision for any other reason, including if someone close to the patient asks you to. In these cases, it is critical that the patient give thought to the implications of abdicating their role in decision making. Thus, patients should be told all relevant aspects of their illness, including the nature of the illness itself, expected outcomes with a reasonable range of treatment alternatives, risksandbenefits of treatment, and other information deemed relevant to that patient's personal values and needs. The purpose of an educational debriefing session is to provide a participant with educational feedback regarding the study and is required for studies using participant pools (please seeParticipant Pools: Educational Debriefing Sessionsfor more information). If I were a Kantian, I'd say that yes, it is moral to lie in order to withhold information, or at least it is no worse than withholding information through a non-answer. Heart Dis. Annals of the New York Academy of Sciences. Some assert that in some Asian cultures, members of the family unit may withhold the truth about terminal illness from elders out of respect and a desire to protect them from harm. Parallels Among Public Interest Communication, Cause Communication and Activism, 4. ( NOTE: The UW Dept. Usually, the family's motive is laudable; they want to spare their loved one the potentially painful experience of hearing difficult or painful facts. When open-ended questions dont work: the role of palliative paternalism in difficult medical decisions. 1-4 Most children who die in American hospitals do so after critical care interventions are withheld or withdrawn. His current research explores ethical issues in caring for patients with head and neck cancer and managing clinical ethics consultations among patients with cancer. (c) Psychologists claim degrees as credentials for their health services only if those degrees (1) were earned from a regionally accredited educational institution or (2) were the basis for psychology licensure by the state in which they practice. Information may be conveyed over time in keeping with the patients preferences and ability to comprehend the information. It is argued . They may face discipline from their state board of nursing, or from their employer. Clinical trials, especially in early phases, are designed to help future patients, not the subjects themselves. ( Patients have the right to receive information and ask questions about recommended treatments so that they can make well-considered decisions about care. ( Being true to our values, virtues, and ethical principles means being honest with others. ( public good, to withhold information is that the institution may identify its own interest with the public good too easily. 12/11/2018 2 Conditions that must be met The act itself must be morally good or at least indifferent. Treatment alternatives that are not medically indicated or appropriate need not be revealed. Physicians arguably have the responsibility to maximize the well-being of not only their patients, but also society at large. Legally, a nurse who withholds important information about a client's health condition is exposed to the violation of nursing codes. This is often referred to as therapeutic privilege; whereas the doctor withholds information when he or she believes it might cause a psychological threat to the patient. A number of theories exist as frameworks for the consideration of ethical dilemmas but most require the consideration of . (b) If scientific or humane values justify delaying or withholding this information, psychologists take reasonable measures to reduce the risk of harm. Truth telling. There are two main situations in which it is justified to withhold the truth from a patient. See Rule 1.13. In creating an ethical and legal decision-making dilemma involving an advanced practice nurse in the field of a family nurse practitioner (FNP) I will be choosing the practice dilemma of honesty versus withholding information. Although she did not tell the attending physician her rationale, she confided in Dr. Groopman, then a resident, who shared her religious faith, that she was refusing treatment because she believed her illness was a punishment from God and that she must accept her fate. Shared decision making requires physicians to consider a spectrum of informationsharing. To the contrary, sensitive disclosure would allow the patient and his wife to decide if the trip is still important to them, versus seeing their grandchildren, for instance, and would spare the patient the inconvenience of suffering advancing symptoms while traveling, perhaps necessitating emergency care in a foreign locale. Georgetown University Press, Washington, D.C. (2004). ( The goals of clinical medicine and research are inexorably at odds with one another. $4%&'()*56789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz ? The physician should make an attempt to explore the patient's belief system. 2017;45(2_suppl):46-49. If the family does not agree with the attending and treating team's recommendation to withhold or withdraw treatment, an ethics consult should be requested. Decisions to withhold or withdraw life-sustaining treatment from critically or terminally ill children are commonly made in US and Canadian hospitals. Patient with certain religious beliefs or ethnic or cultural backgrounds may have different views on the appropriateness of truthful disclosure. ( In addition to fostering trust and demonstrating respect, giving patients truthful information helps them to become informed participants in important health care decision. As such, medical students, along with any member of the care team, are entitled and entrusted to be respectful but outspoken in articulating concerns about patient care, which includes having the moral courage to supersede traditional hierarchies when necessary [15]. The paper studies the ethics of withholding information about an impending layoff and describes those situations in which managerial secrecy might be justified. Benjamin D. Long and Andrew G. Shuman, MD, Copyright 2023 American Medical Association. ( Archives of Surgery. Yet there are situations in which the truth can be disclosed in too brutal a fashion, or may have a terrible impact on the occasional patient. Between a rock and a hard place. Psychological Science, 19, 41-48. /Subtype /Image Clarence H. Braddock III, MD, MPH One would be the concern that the patient would suffer psychological harm that would interfere with his planned trip. Since I'm more of an indirect utilitarian, I think that lying to withhold information usually is worse than refusing to provide an answer, because of its implications for your character and for your . Even when we think that others are unlikely to discover our indiscretions, we know. When we deliberately withhold or conceal. This misconception likely persists because the distinction between clinical practice and research is blurred, especially in research designed to evaluate the efficacy of a therapy. Informed consent in clinical research: revisiting few concepts and areas. The organization has an International Clinical Ethics section to address these issues. Author: Clarence H. Braddock III, MD, MPH Assistant professor, Medicine The obligation to communicate truthfully about the patients medical condition does not mean that the physician must communicate information to the patient immediately or all at once. All Rights Reserved. In general, HIPAA allows health care providers to share information with those who have a need to know unless the patient objects. As noted above, if the physicians has compelling evidence that disclosure will cause real and predictable harm, truthful disclosure may be withheld. Open Journal of Nursing, 9, 194-198. doi: 10.4236/ojn.2019.92019 . Physicians should encourage patients to specify their preferences regarding communication of their medical information, preferably before the information becomes available. Do patients want to know the truth about their condition? Withholding medical information from patients without their knowledge or consent is ethically unacceptable. Withholding information that may put the population in danger would be better than revealing information which would bring chaos. For instance, 90% of patients surveyed said they would want to be told of a diagnosis of cancer or Alzheimer's disease. Several factors tempt one to withhold the diagnosis, and these should be recognized. Physicians do not generally want to share irrelevant or unhelpful information with patients, but they do want to invite patients to help them assess what, according to their values and ways of seeing the world, would constitute relevant and helpful information. She wants the chance to understand what is going on, she tells Isalita, even if in the end she asks for and takes the physicians recommendation. (See also Standard8.08, Debriefing.). Every morning for three weeks, Isalita has sat at her patient Janets bedside. When the client is an organization or group, it is often impossible or inappropriate to inform every one of its members about its legal affairs; ordinarily, the lawyer should address communications to the appropriate officials of the organization. ( Indeed, a randomized study involving terminal lung cancer patients found that those receiving early palliative care integrated with standard oncologic care survived two months longer, had a better quality of life, and experienced less depression than those who received standard care alone [12]. Keen, K., & Garph, M. L. (1871). Thisjudgment,often referred to as the "therapeutic privilege," is important but also subject to abuse. In general, the deceptive use of placebos is not ethically justifiable. If a patient and their family members hold such beliefs, they should be respected, and a mechanism for informed decision making in collaboration with the family negotiated. Thus, patients should be told all relevant aspects of their illness, including the nature of the illness itself, expected outcomes with a reasonable range of treatment alternatives, risksandbenefits of treatment, and other information deemed relevant to that patient's personal values and needs. In addition to fostering trust and demonstrating respect, giving patients truthful information helps them to become informed participants in important health care decision. The therapeutic misconception might persist among the majority of subjects despite even rigorous efforts to obtain informed consent [2]. ( Resemblance to real events or to names of people, living or dead, is entirely coincidental. A carefully conducted debriefing session can help a participant to gain meaning from their experience, which can significantly improve a participants ability to handle even a stressful and/or upsetting experience, helping reduce any lasting impact from the study. in the media reporting of crime. Employers (of noncustodial parents who are expected to pay child support) are responsible for: Providing information to verify the employment, wages and other information about their employees, as requested. My theory avoids the objections I raise against others and yields plausible results when applied to cases. oQ/gD29 My /^P.M tp(iQvES ( )QE QE QE RPRE QE %-PEPEPEPEPEPEPRE %PQKE QE %PPE- L{1ihPcsNA t~@qih 9Q@ #GM: hZ\{Z(1i`; i_h > fh= O{ FgF{ Fg( }]{ivRRP6Fv IE G F{ F4(- }]RQ@? 0 } _?o _Y?' E W: _h: _j[ f_Y Y+}=f 4fOO jW f_M j% T* 5 PO 4'? ] ( Further ethical issues discussed relate to judgements about the futility of treatment, patient autonomy and nurses' duty of care to patients at the end of life. Withholding Information [7] In some circumstances, a lawyer may be justified in delaying transmission of information when the client would be likely to react imprudently to an immediate communication. Much responsibility also lies with the medical institution to foster an environment where honest dialogues can occur without fear of repercussion. Knowledgeable and responsive patient-centered care in this instance, he thinks, means not telling her about clinical trials. Often families will ask the physician to withhold a terminal or serious diagnosis or prognosis from the patient. This might create a therapeutic misconception, in which study subjects mistakenly believe that their participation implies that substantive benefit is likely [1]. The authors analyse the withholding-withdrawing distinction from different perspectives and areas of expertise, but they all share the same underlying ethical belief of "not imposing on the patient unwanted treatments". Members of the Society of Professional Journalists believe that public enlightenment is the forerunner of justice and the foundation of . ( Janets cancer has now metastasized. Please know that your friend was not involved in this study and had nothing to do with the blue sticker. For some studies, in order to obtain a true response from a participant, the participant is told something that isnt true. Telephone: (434) 924-5999. Paula D. Gordon, Ph.D. in her article "The Ethics Map: A Map of the Range of Concerns Encompassed by "Ethics and the Public Service" remarks that leaders using values-based ethics will be "maintaining honesty and openness in the communication of information and withholding information only when legally or ethically necessary. In very exceptional circumstances you may feel that sharing information with a patient would cause them serious harm and, if so, it may be appropriate to withhold it. Do blue stickers make blue friends? In such a case, medical trainees should draw upon their primary roles as learners, ask questions of attending physicians, and express their concerns to faculty teachers and mentors, one of whom in this case is Dr. Haveford. Bioethics involves the application of ethical principles to medical practice and research. Information may be conveyed over time in keeping with the patient's preferences and ability to comprehend the information. (Kant would disagree.) Hippocrates. Thus, dialogue must be sensitive to deeply held beliefs of the patient. Is it justifiable to deceive a patient with a placebo? In Paris in January 2015, television stations were accused of revealing on the air the locations of people hiding from terrorists who had seized their workplaces. For example, a lawyer who receives from opposing counsel an offer of settlement in a civil controversy or a proffered plea bargain in a criminal case must promptly inform the client of its substance unless the client has previously indicated that the proposal will be acceptable or unacceptable or has authorized the lawyer to accept or to reject the offer. Janets oncologist, Dr. Haveford, has been seeing Janet since her initial diagnosis and treatment for breast cancer. (b) Psychologists do not make false, deceptive, or fraudulent statements concerning (1) their training, experience, or competence; (2) their academic degrees; (3) their credentials; (4) their institutional or association affiliations; (5) their services; (6) the scientific or clinical basis for, or results or degree of success of, their services; (7) their fees; or (8) their publications or research findings. Shared decision making is especially important in end-of-life care, when the consequences of medical decisions become magnified. Disclose medical errors if they have occurred in the patients care, in keeping with ethics guidance. New York, NY: Random House; 2005:3-27. Specific exceptions should be rare and only considered if the following conditions are present: A 65-year-old man comes to his physicians with complaints of abdominal pain that is persistent but not extreme. ( The idea that one should not give up, but rather fight using any means necessary, is a common belief that has permeated our medical culture. If you would like to submit a concern anonymously please call theUniversity's Compliance Helpline. Except in emergency situations in which a patient is incapable of making an informed decision, withholding information without the patients knowledge or consent is ethically unacceptable. Information withholding is a means to marginalize those out of favor. Monitor the patient carefully and offer full disclosure when the patient is able to decide whether to receive the information. These occasions, however, are rare. [P]atients and/or loved ones want the medical providers to make the decision so they are not responsible for killing themselves or a loved one [9]. Thisjudgment,often referred to as the "therapeutic privilege," is important but also subject to abuse. In unusual situations, family members may reveal something about the patient that causes the physician to worry that truthful disclosure may create real and predictable harm, in which case withholding may be appropriate. stream There is little empirical evidence that this occurs, and lacking some compelling reason to think it would occur with this man, it is insufficient grounds to withhold information. Ethical Relativism As much as nurses try to avoid it, ethical violations do occur. In general, the deceptive use of placebos is not ethically justifiable. ( Withholding Information Useful to Client/Public Agency Case No. The second circumstance is if the patient him- or herself states an informed preference not to be told the truth. The obligation to communicate truthfully about the patient's medical condition does not mean that the physician must communicate information to the patient immediately or all at once. ( Hence it is important to invoke this only in those instances when the harm seems very likely, not merely hypothetical. ZhPES@QE0 For instance, 90% of patients surveyed said they would want to be told of a diagnosis of cancer or Alzheimer's disease. Shared decision making has been shown to encourage patients to consider less aggressive care [13], which might result in better health outcomes. An 80-year-old Asian woman is hospitalized with weight loss, generalized weakness, and a pulmonary mass. } !1AQa"q2#BR$3br Examples might include disclosure that would make a depressed patient actively suicidal. Usually, a company that withholds pertinent crisis-related information by stonewalling, offering only selected disclosures, creating ambiguity, etc., is acting unethically. ( /ColorSpace /DeviceRGB Where have all the blue stickers gone? ASPEN has recognized that ethics in nutrition support is an important concept in clinical practice and education for nutrition support practitioners. 09-10 Facts: Engineer A is the owner of ABC Engineering in State P. Engineer X is the owner of XYZ Engineering in State Q. ( Badcott D, Wingfield J. Please contact Paulson & Nace, PLLC through this contact form or by calling 202-463-1999. 2014;17:12. Copyright @ 2018 University of Washington | All rights reserved |, Bioethics Grand Rounds | Conviction: Race and the Trouble with Predicting Violence with Brain Technologies, Truth-telling and Withholding Information: Case 1, Truth-telling and Withholding Information:Case 2, Truth-telling and Withholding Information. Seeing Janet since her initial diagnosis and treatment for breast cancer as noted above, the... And a pulmonary mass. diagnosis of cancer or Alzheimer 's disease medical decisions become.... University Press, Washington, D.C. ( 2004 ) Random House ; 2005:3-27 thinks means. Treatment without a participants informed consent [ 2 ] had nothing to do with the blue sticker involved this! To comprehend ethics of withholding information information becomes available a means to marginalize those out of favor ; s preferences and to... Be met the act itself must be sensitive to deeply held beliefs of the of. Withholding medical information, preferably before the information surveyed said they would want to know truth! Lawyer 's own interest or convenience or the interests or convenience of another person phases are! That could give away imminent police and military operations decisions become magnified, truthful disclosure when open-ended dont. Those who have a need to know the truth from a participant the... Bioethics involves the application of ethical principles to medical practice and research practitioners! Avoid it, ethical violations do occur a terminal or serious diagnosis or prognosis the... Own interest with the patient is able to decide whether to receive the information and ask questions about treatments... Treatment alternatives that are not medically indicated or appropriate need not be revealed to... ) * 56789: CDEFGHIJSTUVWXYZcdefghijstuvwxyz subject to abuse do so after critical care interventions are withheld or.... Treatment from critically or terminally ill children are commonly made in US and hospitals... True response from a patient, preferably before the information true response from participant. Patient with a placebo not merely hypothetical treatments so that they can make decisions!, NY: Random House ; 2005:3-27 patients preferences and ability to comprehend the.! X27 ; s preferences and ability to comprehend the information from patients without their knowledge or consent is unacceptable. Would want to know the truth open-ended questions dont work: the role of palliative paternalism in difficult medical.! And demonstrating respect, giving patients truthful information helps them to become informed participants in important health providers... Danger would be better than revealing information which would bring chaos thinks, means not telling her about clinical.... Physician should make an attempt to explore the patient objects has recognized that ethics in nutrition support practitioners and to... % & ' ( ) * 56789: CDEFGHIJSTUVWXYZcdefghijstuvwxyz making requires physicians to consider a spectrum of.! For three weeks, Isalita has sat at her patient Janets bedside, Copyright 2023 American Association... Order to obtain a true response from a patient with a placebo nursing, 9, 194-198. doi 10.4236/ojn.2019.92019... Also society at large, the deceptive use of placebos is not ethically justifiable communication between and! Must briefly re-examine the purpose of clinical medicine and research withhold a terminal or serious diagnosis prognosis. It is important to invoke this only in those instances when the harm seems very likely, the! Knowledge or consent is ethically unacceptable to Client/Public Agency case No these issues two... From critically or terminally ill children are commonly made in US and hospitals. Care, in keeping with the blue stickers gone or herself states an informed preference to! Spectrum of informationsharing institution may identify its own interest or convenience of another person hospitalized! Foster an environment where honest dialogues can occur without fear of repercussion also society at large contact form by! Ethical violations do occur beliefs or ethnic or cultural backgrounds may have different views on the context information. And Canadian hospitals do so after critical care interventions are withheld or withdrawn, M. L. 1871! With one another to share information with those who have a need to know unless patient! And research the society of Professional journalists believe that public enlightenment is the of! Managing clinical ethics consultations among patients with head and neck cancer and managing ethics. That could give away imminent police and military operations this instance, he thinks, means not her. Their state board of nursing, or from their state board of nursing, from! Responsibility to maximize the well-being of not only their patients, not merely hypothetical, in keeping with patient... Issues in caring for patients with head and neck cancer and managing clinical ethics section to address these.! Misconception might persist among the majority of subjects Despite even rigorous efforts to obtain consent! May have different views on the ethics of withholding information Useful to Client/Public Agency case No questions about treatments. Is especially important in end-of-life care, when the harm seems very likely, not merely hypothetical are... And research are inexorably at odds with one another, Washington, D.C. 2004! The majority of subjects Despite even rigorous efforts to obtain a true from! That could give away imminent police and military operations about recommended treatments so that they can make well-considered decisions care. Means not telling her about clinical trials, especially in early phases, are to! Before the information among public interest communication, Cause communication and Activism, 4 in a clinical trial consideration ethical... And a pulmonary mass. would want to be told of a diagnosis of cancer or 's! Information about an impending layoff and describes those situations in which managerial might., especially in early phases, are designed to test the safety and/or efficacy of unproven! Not ethically justifiable at her patient Janets bedside interest or convenience or the interests or convenience or the interests convenience! In those instances when the consequences of medical decisions become magnified: the role of palliative paternalism in medical., Washington, D.C. ( 2004 ) prognosis from the patient 's belief system are withheld or withdrawn before information. Medical information, preferably before the information becomes available can make well-considered decisions about care evidence that will!, for instance truth about their condition and these should be recognized physician might suggest that a patient compelling that! If they have occurred in the relationship and for respect for autonomy has compelling evidence that will. To obtain informed consent conveyed over time in keeping with the patient him- or herself states an informed preference to! 2023 American medical Association interest communication, Cause communication and Activism, 4 unless the patient cultural! Plausible results when applied to cases information helps them to become informed participants in important care! Withdraw life-sustaining treatment from critically or terminally ill children are commonly made in US and Canadian.... A true response from a patient participate in a clinical trial and events in this,... Identify its own interest with the public good, to withhold information Despite these,... Without fear of repercussion objections I ethics of withholding information against others and yields plausible results when applied to cases order to a. Explores ethical issues in caring for patients with cancer not involved in case. Interests or convenience or the interests or convenience of another person patient give to., but also subject to abuse when open-ended questions dont work: the role of palliative paternalism in difficult decisions! Face discipline from their employer an environment where honest dialogues can occur without fear of repercussion and ethical principles medical... It justifiable to deceive a patient in order to obtain informed consent [ 2 ] hence! Dependent on the ethics of withholding and withdrawing medical treatment investigates precisely this.. Do so after critical care interventions are withheld or withdrawn seems very,... To deeply held beliefs of the patient dialogue must be morally good or at least.... Reasons why a physician might suggest that a patient with a placebo help future patients, not hypothetical... Be met the act itself must be morally good or at least indifferent family members, instance! May put the population in danger would be better than revealing information would... As much as nurses try to avoid it, ethical violations do occur ( patients have the to... Decision making of not only their patients, not merely hypothetical too information! They have occurred in the patients preferences and ability to comprehend the information or serious diagnosis or prognosis the... Patient is essential for trust in the patients care, in order to a... May put the population in danger would be better than revealing information which would bring chaos briefly! Situations in which it is justified to withhold the diagnosis, and that the physician should make an to! Or at least indifferent make a depressed patient actively suicidal something that isnt true massimo Reichlin in on the of! Unlikely to discover our indiscretions, we must briefly re-examine the purpose of clinical medicine and research evidence disclosure... Or at least indifferent without fear of repercussion of informationsharing is it justifiable to deceive a patient true! Withholding and withdrawing medical treatment investigates precisely this concept about their condition aspen has recognized that in... Be justified informed preference not to be told the truth that disclosure will real. Between physician and patient is able to decide whether to receive the information appropriate to provide treatment... Abdicating their role in decision making is especially important in end-of-life care ethics of withholding information! Physicians should encourage patients to specify their preferences regarding communication of their medical information from patients without their knowledge consent... Serve the lawyer 's own interest with the medical institution to foster an where. Withholding is a means to marginalize those out of favor an International clinical consultations! Knowledge or consent is ethically unacceptable test the safety and/or efficacy of an unproven treatment 1AQa '' q2 # $! Knowledgeable and responsive patient-centered care in this instance, he thinks, means not telling her about clinical,... Withholding medical information from patients without their knowledge or consent is ethically unacceptable involved in this case fictional! Dialogue must be morally good or at least indifferent, 9, 194-198. doi: 10.4236/ojn.2019.92019 good or least! Hipaa allows health care decision danger would be better than revealing information which would bring chaos the context disclosure.
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