Informed consent is one of the principal values in healthcare, but it should include discussions about cost, said Jacqueline Glover, PhD, professor in the Department of Pediatrics and the Center for Bioethics and Humanities at the University of Colorado Denver. Glover also discussed the need to clarify the language surrounding end-of-life care.
Informed consent is one of the principal values in healthcare, but it should include discussions about cost, said Jacqueline Glover, PhD, professor in the Department of Pediatrics and the Center for Bioethics and Humanities at the University of Colorado Denver. Glover also discussed the need to clarify the language surrounding end-of-life care.
Transcript (slightly modified)
Where do values from different stakeholders overlap from an ethics perspective?
I think all different stakeholders, whether its healthcare professionals, patients, families, communities, companies, society, we all share the values of transparency and truthfulness, respecting choice within certain parameters, increasing well-being, decreasing risks, and allocating fairly. I think the least controversial overlap, and the place we should begin, is with informed consent.
On the individual level, physicians and other providers should normalize that cost is part of informed consent. If they don’t have the information about cost, they should normalize the discussion and have information about how a patient could get the exact numbers. One of our hospitals, a small hospital, has the practice of a designated oncology pharmacist. That person looks up for each individual patient, what would their out-of-pocket cost be.
I think that’s the kind of thing that we should do. Not necessarily the physician, but the physician has to normalize that discussion. It’s okay to have concerns about cost, and here’s information that can help you make decisions based on cost. It’s hard to scale, it’s a very small hospital, and having an oncologist to look up your individual out-of-pocket cost, that’s hard to scale.
But I think the least controversial is to provide information to patients who may want to say, “Oh, I didn’t realize that the benefit was only a chance at 3 more months for $150,000. I can’t afford that, and I don’t want to burden my family with that after I’m dead.” I think that’s the least controversial.
We tend to use very revealing language. We talk about withdrawing care, and we never withdraw care; we withdraw treatments or we don’t start treatments or interventions. People are afraid that if they didn’t do the next drug, the next innovative thing, that they don’t know what would happen. They would have nothing. They said, “your choice is either do this drug or have nothing.” Well, that’s not true.
As one participant said, if we had palliative care discussions alongside of discussions more frequently, patients could realize that it’s not necessarily all or nothing. It’s this or palliative care and hospice care. We never withdraw care. We just shift the emphasis on care to trying for that additional 3 months versus keeping a person comfortable and doing the things that are necessary at the end of life.
ATS 2024: Bridging the Past, Present, and Future of Respiratory Care
May 16th 2024The application of artificial intelligence in medicine is anticipated as a highlight of ATS 2024, with sessions exploring its applications in research, radiological interpretation, and pediatric pulmonology.
Read More
The Importance of Examining and Preventing Atrial Fibrillation
August 29th 2023At this year’s American Society for Preventive Cardiology Congress on CVD Prevention, Emelia J. Benjamin, MD, ScM, delivered the Honorary Fellow Award Lecture, “The Imperative to Focus on the Prevention of Atrial Fibrillation,” as the recipient of this year’s Honorary Fellow of the American Society for Preventive Cardiology award.
Listen
Looking Back on ISPOR 2024: Hot Policy Topics, Welcome Focus on Employers, and More
May 10th 2024Kimberly Westrich, MA, chief strategy officer of the National Pharmaceutical Council, reflects on the most valuable learnings from the 2024 meeting of ISPOR—The Professional Society for Health Economics and Outcomes Research, including lively discussions of the Inflation Reduction Act and workshops on value assessment.
Read More
Promoting Equity in Public Health: Policy, Investment, and Community Engagement Solutions
June 28th 2022On this episode of Managed Care Cast, we speak with Georges C. Benjamin, MD, executive director of the American Public Health Association, on the core takeaways of his keynote session at AHIP 2022 on public health policy and other solutions to promote equitable health and well-being.
Listen
Posters Characterize DMD Caregiver Experiences, Impact of Gene Therapy on Caregiving Demands
May 10th 2024Posters presented at the ISPOR—The Professional Society for Health Economics and Outcomes Research meeting explored Duchenne muscular dystrophy (DMD) caregiver experiences and gene therapy’s impact on work opportunities for caregivers.
Read More
A Focus on Women: AUA Best Posters Highlight Female Athletes, Prenatal Care, and Women in Urology
May 9th 2024Three posters from the American Urological Association (AUA) 2024 Annual Meeting focused on urinary incontinence in female athletes, prenatal care for fetuses with spina bifida in California, and the experiences of women residents at the Brady Urological Institute.
Read More