Should Informed Consent for Cancer Treatment Include a Discussion about Hospital Outcome Disparities 英文参考文献.docVIP

The PLoS Medicine Debate Should Informed Consent for Cancer Treatment Include a Discussion about Hospital Outcome Disparities? Nadine Housri, Robert J. Weil, David I. Shalowitz, Leonidas G. Koniaris B ackground to the debate: Several studies have found disparities in the outcome of medical procedures across disparities among hospitals? Should such information be disclosed as an element of informed consent? In response to one of the initial studies on volume–outcome relationships, Charles Culver and Bernard Gert argued in 1980 in favor of informing patients of volume–outcome disparities, where they exist [36]. However, almost 30 years later, it is questionable whether this information is disclosed during the informed consent process. Based on the principles of informed consent and the prevailing standards of disclosure, we argue that physicians have an ethical obligation to inform patients of hospital outcome disparities for select cancers. different hospitals—better outcomes have been associated with higher procedure volume. An Institute of Medicine workshop found such a “volume–outcome relationship” for two types of cancer surgery: resection of the pancreas and esophagus (/?id=31508). This debate examines whether physicians have an ethical obligation to inform patients of hospital outcome disparities for these cancers. The Scope of Informed Consent in Cancer Care Nadine Housri and Leonidas Koniaris’ Viewpoint: Physicians Have an Ethical Duty to Inform Patients of Hospital Outcome Disparities for Select Cancers Informed consent, which aims to protect the autonomous choice of the patient, is traditionally defined in terms of two components: (1) the disclosure of information on a procedure, leading to the patient’s comprehension of this information; and (2) authorization by the patient to proceed with treatment [37]. Disclosure includes information on the nature of a procedure, potential risks and benefits, and alternative treatments. While patients are theoretical