Canterbury v. Spence, Shared Decision-Making, and The Theory of Informed Consent

• Week 4: Tutorial Questions
Questions:
TQ 4.1: Canterbury v. Spence: The court observes that most courts have analyzed failure-to-disclose cases by looking at “whether it was the custom of physicians practicing in the community to make the particular disclosure to the patient.” Why does the court reject this standard? What standard does it adopt instead? What does the court mean when it says that “the scope of the standard is not subjective as to either the physician or the patient; it remains objective with due regard for the patient’s informational needs and with suitable leeway for the physician’s situation”?
TQ 4.2: Shared Decision-Making: What is “shared decision-making”? What are patient decision aids, and what role do they play in shared decision-making? What are some of the key barriers to the use of shared decision-making? What measures does Pope propose to increase the use of shared decision-making?
Instructions for responses to the Tutorial Questions are available on the Course Information page. For grading information, please see the Tutorial Question rubric in the Assessment Rubrics menu. •Week 4: Discussion Board Question 1
Questions:
DQ 4.1: Many people believe that there is an enormous gap between the theory of informed consent, which is designed to promote active patient participation in medical decision-making, and the realities of everyday medical practice, where many patients simply defer to whatever their health care providers propose, often with little reflection or discussion. Do you agree that there is such a gap? If so, why do you think it exists? Do you think it is problematic? What, if any, steps would you recommend to change the situation?
Instructions for responses to the Discussion Questions are available on the Course Information page. For grading information, please see the Discussion Question rubric in the Assessment Rubrics menu.
• Week 4: Discussion Board Question 2
Questions:
DQ 4.2: Under what circumstances, if any, should providers be required to tell patients about the provider’s receipt of consulting payments from pharmaceutical companies or medical device manufacturers? Would a patient ever be able to bring a successful informed consent case against a provider who fails to make such a disclosure? Are there potential downsides to requiring providers to disclose such information as part of the informed consent process?
Instructions for responses to the Discussion Questions are available on the Course Information page. For grading information, please see the Discussion Question rubric in the Assessment Rubrics menu.
•Activity 4: Designing an Informed Consent Process
You have been asked by a small medical practice to design a process for obtaining informed consent to prostate-specific antigen (PSA) testing. After reviewing this information, as well as any other relevant and authoritative sources you find on the Internet, please draft the following:
• An informed consent form to testing written to conform to the disclosure standard articulated in Canterbury. The form should be concise, easily understandable, and free of any non-essential information. • A one-page document containing links to at least two decision aids about the test (you can find numerous decision aids on the Internet), along with a one-paragraph description of how each decision aid works.
• A one-page cover letter to health care providers, which you will send out along with the two documents above, explaining the purpose of the documents and any other important information you believe providers should know in designing an effective informed consent process
For grading information, please see the Writing Activity rubric in the Assessment Rubrics menu.