title: Ethics, risk, and patient-centered care: how collaboration between clinical ethicists and risk management leads to respectful patient care.
abstract: Patient-centered care is driven in part by the ethical principle of autonomy and considers patients' cultural traditions, personal preferences, values, family situations, and lifestyles. Patient decision-making capacity, surrogate decision making with or in the absence of a patient's advance directive, and the right to refuse treatment are three patient-care issues that are central to the work done by both the risk manager and the clinical ethicist that have strong relevance to patient-centered care. This article discusses these three issues briefly and offers two challenging case studies involving patient-centered care that illustrate how a clinical ethics consultation may help to avert the escalation that can lead to a tort claim.
authors.affiliation: National Center for Patient Safety, the Veterans Health Administration, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Sine
authors.forename: Virginia A
authors.initials: VA
authors.lastname: Sharpe
mesh_terms: D000328:Adult; D016223:Advance Directives; D000368:Aged; D003299:Cooperative Behavior; D026690:Ethics, Clinical; D005260:Female; D006801:Humans; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D012308:Risk Management; D016312:Treatment Refusal; D014481:United States