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1st Monday, January 19, 2013

Are you weary of the noises or the people that you have to live with? It may seem silly to ask, but apparently, it’s not. I get asked from time to time by clients whose lives were never spared from that essential consideration. Sadly, it seems to be an all too common discussion point in the homes of clients with psychological disorders as it occurs in the health care industry at large.

As has often been noted and is frequently quoted, the physician has a fiduciary obligation to his or her patient. The fiduciary relationship recognizes that a patient is not always capable of making best decisions about the care he or she needs. By virtue of this relationship, the physician has ethical obligations to make reasonable efforts to ensure that the patient’s decisions are sound. Thus, the broad policy regarding the duty to warn has received some attention in the medical community, but the issue is frequently a source of confusion. What is the duty to warn? There are a number of different rules that govern the issue, and in some cases, there are times when the duty to warn may be carried to the point of being an express or affirmative duty. The good news is that most courts, in the absence of legislative guidance have concluded that the duty to warn is an ethical one that flows from the relationship between physician and patient.

It is no surprise that the duty to warn exists because it is, in essence, the obligation to ensure that a patient makes the best decision possible. It is certainly helpful to know that even in the absence of explicit advice, most courts have recognized that warnings about possible side effects and other risks inherent in the therapy provided are necessary to ensure that the patient makes a decision that is, in fact, sound.

The other side of the discussion is the rule that, when a physician advises on a matter of medical treatment, the physician may be ethically obligated to disclose all information that is known, or that the physician reasonably believes is material to the patient’s decision-making. The alternative

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