Transparency in Health and Health Care in the United States最新文献_第3页

Introduction to Part VI 第六部分简介

Transparency in Health and Health Care in the United States Pub Date : 2019-06-06 DOI: 10.1017/9781108658867.026

I. Cohen

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Transparency on Prescription Drug Research Expenditures 处方药研究支出的透明度

Transparency in Health and Health Care in the United States Pub Date : 2019-06-06 DOI: 10.1017/9781108658867.012

A. Sarpatwari, J. Avorn, A. Kesselheim

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Smashing into Windows 砸窗户

Transparency in Health and Health Care in the United States Pub Date : 2019-06-06 DOI: 10.1017/9781108658867.003

B. Furrow

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Introduction to Part II 第二部分简介

Transparency in Health and Health Care in the United States Pub Date : 2019-06-06 DOI: 10.1017/9781108658867.007

Luke Gelinas

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Transparency versus Informed Consent 透明度与知情同意

Transparency in Health and Health Care in the United States Pub Date : 2019-05-20 DOI: 10.1017/9781108658867.008

C. Konnoth

{"title":"Transparency versus Informed Consent","authors":"C. Konnoth","doi":"10.1017/9781108658867.008","DOIUrl":"https://doi.org/10.1017/9781108658867.008","url":null,"abstract":"Before transparency became the buzzword in bioethics and health policy that it is today, it was somewhat parasitic on another familiar concept: that of informed consent. In 1989, Howard Brody offered what has come to be known as the “transparency model” of informed consent. In his elaboration of the model, Brody argued that the key to informed consent was making the treatment process legible to the patient. Transparency remained part of the informed consent process in both academic and policy circles. A decade after Brody, Bill Sage observed that “disclosure obligations have been imposed by courts” in part to help vindicate “informed consent by physicians.” The seminal 2001 report from the Institute of Medicine, “Crossing the Quality Chasm: A New Health System for the 21st Century” similarly observed, “Transparency is necessary [to] make available to patients and their families information that enables them to make informed decisions when selecting a health plan, hospital, or clinical practice, or when choosing among alternative treatments.” \u0000This chapter seeks to make three predominantly descriptive-evaluative (rather than prescriptive) points. The first claim, which I engage with in the most detail, is that informed consent and transparency – at least as the term is widely used today – are tethered to different narrative and ethical paradigms. Informed consent implicates the traditional model of the care-recipient as patient. Transparency implicates a newer model of the care-recipient as consumer. These narratives correspond to different ethical frameworks and to different contexts. The former better corresponds to a vision of autonomy where the individual is rendered autonomous through the relationship she builds with others. Transparency, by contrast, is more consonant with an absolutist, Kantian sense of autonomy, which takes the individual as a developed decision maker that merely needs data in order to compute the correct outcome. \u0000Second, the paradigms separate the contexts that constitute the health-care system. Health care involves various contexts and social roles. These include traditional clinical contexts in which patients interact with their doctors. But they also include interactions that do not traditionally fall within this category such as shopping for elective procedures, medical supplements, or insurance. Informed consent can be understood as a ritual that tells the actors within the health system which social role they are occupying. Maintaining some degree of separation between our understanding of the practices helps maintain sickness and medical care as contextually distinct areas of human interaction. This separation serves important social functions by determining, for example, when individuals are entitled to care and social support, and when they are not. \u0000Finally, the discourse someone deploys – transparency or informed consent – demonstrates their own normative priors as to whether a particular activity should be co","PeriodicalId":225313,"journal":{"name":"Transparency in Health and Health Care in the United States","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132047269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Transparency Challenges in Reproductive Health Care 生殖保健中的透明度挑战

Transparency in Health and Health Care in the United States Pub Date : 2018-02-01 DOI: 10.1017/9781108658867.025

D. Fox

{"title":"Transparency Challenges in Reproductive Health Care","authors":"D. Fox","doi":"10.1017/9781108658867.025","DOIUrl":"https://doi.org/10.1017/9781108658867.025","url":null,"abstract":"Few medical specialties in the United States are as opaque as assisted reproductive technology (ART). ART operates free of regulation about serious and preventable kinds of errors that might be called ART “never events”: the destruction, contamination, misdiagnosis, and switching of materials that cannot be chalked up to inevitable slips of hand or reasonable lapses in judgment. Elsewhere in health care delivery, these kinds of mistakes — surgery on the wrong body part or patient, for example — are publicly reported by mandate in 25 states and the District of Columbia. But no system exists to track similar such transgressions when they take place at fertility clinics, sperm banks, egg vendors, or surrogacy agencies. \u0000 \u0000Crowd-sourcing can help enhance market transparency about ART never events in the absence of regulation or remedy under public law, private law, or professional associations. This chapter introduces a user-generated platform that solicits reflections from reproductive patients about the care they received. Aggregated and detailed never-event reporting enable patients to select providers who deliver the quality care that’s most relevant to their risks, needs, preferences. This system of patient reviews faces unique challenges, however, beyond the usual concerns about unrepresentative samples, distorted metrics, and the risk of misleading evaluations. It must also account for factors like the stigmatized care, intangible injuries, and out-of-pocket expenses that distinguish medical treatment within the reproductive context.","PeriodicalId":225313,"journal":{"name":"Transparency in Health and Health Care in the United States","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128822342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Transparency Trade-offs 透明的权衡

Transparency in Health and Health Care in the United States Pub Date : 1900-01-01 DOI: 10.1017/9781108658867.005

G. Persad

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