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

Risk Avoidance

Clinicians are not required either ethically or legally, to treat every patient that presents for treatment. There are times when the clinician-patient relationship should be terminated for the benefit of the patient as well as the clinician.

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It is important to note the following:
Confidentiality does not “die” with the patient.
Every clinician is required to maintain a record on every patient.


You should always inquire of new patients as to whether they are involved in, or plan on becoming involved in, litigation that may include you.
●  Don’t write anything in a patient’s record that you would not want them to see.
●  Never write a letter on behalf of a patient that you could not defend in a court of law.
●  Never agree to refrain from maintaining a record on a patient.
●  Never change a record without making such change in a manner that will be transparent to anyone who reads it later.


Clinicians are not required either ethically or legally, to treat every patient that presents for treatment.
There are times when the clinician-patient relationship should be terminated for the benefit of the patient as well as the clinician.


The difference between a proper termination and a claim of abandonment is related to the process of termination. Abandonment is usually a precipitous act without notice to the patient or lacking a valid explanation. A proper termination involves a dialogue with the patient usually resulting in a transfer of the patient to a new provider.
In a psychotherapeutic relationship, gifts and compliments should be kept to a bare minimum; both in quality and quantity.


When a psychiatrist allows a patient’s outstanding bill to accumulate to a level where the patient is angry over the amount, the fault no longer lies with the patient. Prescriptions may only be written for legitimate medical purposes. This requires a clinician- patient relationship, and a medical history and exam. Medication prescribed by a physician should be warranted by, and consistent with, the diagnosis, and maintenance of a medical record is of utmost importance.


Physicians should never provide samples of medication to a patient without first placing the sample medications in a container with the physician’s name and address, patient’s name, name of the drug, dosage, strength per dosage unit, directions for use, and any cautionary statements.

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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.

Read More »

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.