![]() Patients are making, or at least may be making, informedĭecisions about their health care, or that the decision Without some level of certainty or evidence to the contrary, clinicians and ethicists should assume their Harmful to the patient (duty to nonmaleficence). Wishes (i.e., respect the autonomy) of patients they thinkĪre in unrealistic belief states, unless clinicians and ethicists know these unrealistic belief states are or will be Blumenthal-Barby and Ubel argue thatīecause hope and unrealistic belief states are not as obviously parsed as the standard bioethical thinking claims,Ĭlinicians and ethicists should be more permissive of the Is to balance principles against each other, giving primacy to autonomy.įrom this underlying assumption, the authors challenge the “basic distinction” between hope and unrealistic belief states. Superseding duty to nonmaleficence-that is, theĪssumption that in these cases the work of clinical ethics They perceive as patients’ potentially autonomous decision making unless they perceive harms that justify a In doubt, clinicians and ethicists should default to what ![]() The assumption that emerges in their article is that when To do clinical ethical work, and signposts important consequences for patient care and clinician responsibility. Unrealistic belief states is enlightening because it revealsĬommitments to and assumptions about what it means That is to say: this approach, in attempting to provide a more ethical way to care for patients, may lead clinicians and ethicists to avoid the work of clinical ethics.īlumenthal-Barby and Ubel’s approach to the question of how medicine and ethics should respond to Understanding patient belief states with any sort of rigor This more permissive response may lead to the unintendedĬonsequence of allowing-or even advocating for-clinicians and ethi cists to avoid investigating, probing, and Permissive of patients’ various belief states rather than To respect patients by not assuming authority over themĪnd dismissing their mental states out of hand: to be more Many others) humility and openness are needed to takeĬare of patients. Will call “unrealistic belief states”), in this context (and On unrealistic optimism, denial, and self-deception (what I While patients may appear to be making decisions based Patients do about what’s best for those patients, and that Under the assumption that they know better than their Key point to explore is the authors’ reminder to cliniciansĪnd ethicists that they ought not interact with patients Through their analysis of patients’ belief states and howĬlinicians and ethicists might respond to those states. Unrealistic Optimism, and Self-Deception, The American Journal of Bioethics, 18:9, 36-37, DOI:įull Terms & Conditions of access and use can be found atĪndy Kondrat, Cedars-Sinai Medical Centerīlumenthal-Barby and Ubel’s target article (2018) providesĪ valuable contribution to the work of clinical ethics To cite this article: Andy Kondrat (2018) The Unintended Consequences of Reframing Denial, ISSN: 1526-5161 (Print) 1536-0075 (Online) Journal homepage: ĭenial, Unrealistic Optimism, and Self-Deception
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