Excerpt From Medical Ethics: Real-World Application By Afshin Nasser

Informed Consent

Medical decision-making is ideal in a setting where patients are empowered to make informed decisions regarding their health by being provided with adequate information regarding their health with respect and acceptance.

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Medical decision-making is ideal in a setting where patients are empowered to make informed decisions regarding their health by being provided with adequate information regarding their health with respect and acceptance.

Consent is Implied in an Emergency

● Patients have the right to decide on investigations and treatments (patient autonomy). 
● Mentally competent patients have the right to refuse/withdraw consent for treatments. 
● Consent must be voluntary and informed. 
● Patients must have the capacity to give consent. 
● The physician is required to provide pertinent, objective information that a "reasonable" patient would want or need to make an informed decision. 
● Elements of informed consent are diagnosis, proposed treatment, rate of success, risks, alternative treatments, non-treatment consequences, and responses to all questions 
● Consent must be documented in the medical record and is required for each procedure 
● The patient's decision must be respected. 


Q4 Joseph, a 20-year old, presents to the emergency department in excruciating knee pain. She fell on asphalt yesterday while playing soccer and scraped his knee. His knee is now extremely swollen and painful, and he cannot bend or bear weight. You explain to Joseph that he has a septic knee which must be aspirated, and explain the risks associated with the aspiration. You’re not certain that he fully understands the information since he is in such severe pain and appears apprehensive and afraid.

A-begin aspirating the knee
B-Try and locate a family member
C-Reassess if patient is alert and orient to time, place and person
D- attempt to get a verbal consent

Q5 A 60-year-old man has a 2-month history of chest pain and fainting spells. You feel his symptoms require cardiac catheterization. The risks and potential benefits are explained to him and his likely prognosis without the intervention. He verbalizes understanding of all of this but refuses the intervention.
Can the patient legally refuse the said intervention?
A-Yes, as the patient is competent to make this decision, and the doctor has a duty to respect his wishes. B-No, because the patient does not comprehend the severity of his condition.
C-No, because the patient has a life-threatening condition.D-Yes, but the doctor has the duty to obtain a court order.

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State Medical Boards

The medical board’s duty is to protect the public, not the physician. State medical boards today focus on licensed physicians who violate professional ethics, and their mandate has significantly evolved to focus on disciplining physicians.

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Boundary Violation

Boundaries create a therapeutic distance between physician and patient and clarify their respective roles and expectations. Boundaries define limits of the therapeutic relationship.

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Medical Ethics: Real-World Application By Afshin Nasser

You may have acquired this book as a result of conflicts with peers, administrators, patients, or State Medical Boards, where the outcomes of those interactions have left you wondering, “…what if I had done things differently?”

In that case, I hope that this book answers some of your questions and guides you with regards to any future quandaries you may encounter.


If you are a healthcare worker seeking to understand the subject of medical ethics, then I hope this book helps you acquire the clarity you seek.
If you are an individual simply curious about medical ethics, then I raise my hat to you for your pursuit of knowledge.