David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
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American Journal of Bioethics 7 (7):33 – 38 (2007)
Physicians make some medical decisions without disclosure to their patients. Nondisclosure is possible because these are silent decisions to refrain from screening, diagnostic or therapeutic interventions. Nondisclosure is ethically permissible when the usual presumption that the patient should be involved in decisions is defeated by considerations of clinical utility or patient emotional and physical well-being. Some silent decisions - not all - are ethically justified by this standard. Justified silent decisions are typically dependent on the physician's professional judgment, experience and knowledge, and are not likely to be changed by patient preferences. We condemn the inappropriate exclusion of the patient from the decision-making process. However, if a test or treatment is unlikely to yield a net benefit, disclosure and discussion are at times unnecessary. Appropriate silent decisions are ethically justified by such considerations as patient benefit or economy of time.
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Citations of this work BETA
Sylvia Burrow (2012). On The Cutting Edge: Ethical Responsiveness to Cesarean Section Rates. American Journal of Bioethics 12 (7):44-52.
Simon N. Whitney & Laurence B. McCullough (2007). Responses to Open Peer Commentaries on "Physicians' Silent Decisions: Because Patient Autonomy Doesn't Always Come First". American Journal of Bioethics 7 (7):1-3.
Kari L. Karsjens (2007). Exploring the Nature of Physician Intent in "Silent Decisions". American Journal of Bioethics 7 (7):42-44.
Peter H. Schwartz (2007). Silence About Screening. American Journal of Bioethics 7 (7):46-48.
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