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- Title
Consent, Refusal, and Waivers in Patient-Centered Dysphagia Care: Using Law, Ethics, and Evidence to Guide Clinical Practice.
- Authors
Horner, Jennifer; Modayil, Maria; Chapman, Laura Roche; Dinh, An
- Abstract
Purpose: When patients refuse medical or rehabilitation procedures, waivers of liability have been used to bar future lawsuits. The purpose of this tutorial is to review the myriad issues surrounding consent, refusal, and waivers. The larger goal is to invigorate clinical practice by providing clinicians with knowledge of ethics and law. This tutorial is for educational purposes only and does not constitute legal advice. Method: The authors use a hypothetical case of a “noncompliant” individual under the care of an interdisciplinary neurorehabilitation team to illuminate the ethical and legal features of the patient–practitioner relationship; the elements of clinical decision-making capacity; the duty of disclosure and the right of informed consent or informed refusal; and the relationship among noncompliance, defensive practices, and iatrogenic harm. We explore the legal question of whether waivers of liability in the medical context are enforceable or unenforceable as a matter of public policy. Conclusions: Speech-language pathologists, among other health care providers, have fiduciary and other ethical and legal obligations to patients. Because waivers try to shift liability for substandard care from health care providers to patients, courts usually find waivers of liability in the medical context unenforceable as a matter of public policy.
- Subjects
UNITED States; DEGLUTITION disorders; PATIENT refusal of treatment laws; PATIENT-centered care; WAIVER laws; SPEECH therapists; INFORMED consent (Medical law); MEDICAL ethics; PATIENT-professional relations; MEDICAL laws; STATUS (Law); THERAPEUTICS; LAW; DECISION making in clinical medicine; BENEVOLENCE; CONTRACTS; COURTS; DOCUMENTATION; HEMIPLEGIA; PATIENT compliance; TERMS &; phrases; DISCLOSURE; FIDUCIARY responsibility; PATIENT refusal of treatment; REHABILITATION of aphasic persons; PATIENTS' attitudes; STROKE rehabilitation; PATIENT autonomy
- Publication
American Journal of Speech-Language Pathology, 2016, Vol 25, Issue 4, p453
- ISSN
1058-0360
- Publication type
Article
- DOI
10.1044/2016_AJSLP-15-0041