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Week 6: Flow of medical information

A sequential set of cases for discussion this week is included as part of the Discussion Questions

Reminder: There are both Large group and Small group meetings this week.

Required Readings: Textbook

Lo, Resolving Ethical Dilemmas, 3rd ed.:
Chapter 3, Informed Consent (pages 17-27)
Chapter 5, Confidentiality (pages 36-44)
Chapter 6, Avoiding Deception and Nondisclosure (pages 45-53)
Chapter 34, Disclosing Errors (pages 213-220)
Chapter 38, Ethical Dilemmas Facing Students and House Staff, pp. 226-227 only: "Introducing Trainees To Patients"

Recommended Readings: Textbook

Chapter 38, Ethical Dilemmas Facing Students and House Staff, rest of chapter
Jesica's Story (US News and World Report, 2003) Complete Text

Recommended Readings: Articles

Note for this week only: Depending on which essay assignment you choose (if you elect to do an essay for this week's topic), some of the readings below may be required, not recommended. (If no hyperlink is shown for complete text, the article can be found on the ANGEL site.)


Baylis F. 1997. Errors in medicine: nurturing truthfulness. Journal of Clinical Ethics 8:336-339. Fast Take
Scheidermayer, D. 1997. Holding Owen. Journal of Clinical Ethics 8:349-352. Fast Take
Drickhamer MA, Lachs MS. 1992. Should patients with Alzheimer’s disease be told their diagnosis? NEJM 326:947-951. Fast Take
Maguire C, Kirby M, Coen R, et al. 1996. Family members' attitudes toward telling the patient with Alzheimer's disease their diagnosis. British Medical Journal 313: 529-530. Fast Take  Complete Text
Kraman SS, Hamm G. 1999. Risk management: extreme honesty may be the best policy. Annals of Internal Medicine 131: 963-967. Fast Take Complete Text
Comarow A. Jesica's story. U.S. News and World Report, July 28, 2003. Complete Text

Gaming the System

Morreim H. Balancing Act:The New Medical Ethics of Medicine’s New Medical Economics. Selection from Ch. 5. Dordrecht: Kluwer, 1991. Fast Take
Freeman VG, Rathore SS, Weinfurt KP, et al. 1999. Lying for Patients: Physician Deception of Third Party Payers. Archives of Internal Medicine 159 (19): 2263-2270 Fast Take  Complete Text

Informed Consent

Meisel A, Kuczewski M. 1996. Legal and ethical myths about informed consent. Archives of Internal Medicine 156: 2521-2526 Fast Take
Brody, H. 1989. Transparency: informed consent in primary care. Hastings Center Report. September-October: 5-9. Fast Take


Hodge JG, Gostin LO, Jacobson PD.  "Legal issues concerning electronic health information: privacy, quality and liability." JAMA 282: 1466-1471, 1999. Fast Take  Complete Text
Annas GJ. "HIPAA regulation: a new era of medical record privacy?" New England Journal of Medicine 348: 1486-1490, 2003. Fast Take  Complete Text