Physicians' silent decisions: Because patient autonomy does not always come first

American Journal of Bioethics 7 (7):33 – 38 (2007)
Abstract
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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DOI 10.1080/15265160701399735
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References found in this work BETA
The Right and the Good.W. D. Ross - 1930 - Clarendon Press.
The Silent World of Doctor and Patient.Jay Katz - 1984 - Johns Hopkins University Press.
Transparency: Informed Consent in Primary Care.Howard Brody - 1989 - Hastings Center Report 19 (5):5-9.

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Citations of this work BETA
Transparency and Self-Censorship in Shared Decision-Making.Howard Brody - 2007 - American Journal of Bioethics 7 (7):44-46.
Silence is Not Always Golden in Medical Decision-Making.John J. Paris & Michael P. Moreland - 2007 - American Journal of Bioethics 7 (7):39 – 40.
Silence About Screening.Peter H. Schwartz - 2007 - American Journal of Bioethics 7 (7):46-48.

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