Symposium

Ethics

Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)

Balancing Patient Autonomy and Medical Paternalism in Rehabilitation Treatment Planning (824895)

Presenter(s)

• 

  Carolyn K. Cassill, BS

  Doctoral Candidate
  UT Southwestern Medical Center
  Dallas, Texas

  Presentation Slides
• CM

  Carlos Marquez de la Plata, PhD

  Director
  The Neuropsychology and Counseling Center
  Dallas, Texas
• 

  Mary Anise, PsyD

  Neuropsychologist
  Pate Rehabilitation
  Dallas, Texas

  Presentation Slides

One of the primary goals of cognitive rehabilitation therapy is to increase patient autonomy in a manner that maintains the safety of the patient (Cicerone et al., 2011). This may pose some serious practical and ethical challenges, as the patient often demonstrates functional impairments when navigating daily activities which can impact safety.  Unfortunately, the very interventions we commonly utilize for cognitive rehabilitation to facilitate safety often involve medical paternalism. To further complicate matters, there are often several stakeholders involved in making treatment decisions, and at times working in the service of one stakeholder may conflict with the goals of another. As patients progress through treatment, providers are constantly recalibrating the amount of support or leeway they need to give patients. Finding the balance between patient autonomy and medical paternalism is a complex and ongoing conversation that needs more attention.

Learning Objectives:

• Upon completion, participants will be able to describe the nuances of balancing autonomy and medical paternalism
• Understand of difference between decisional and executive autonomy.
• Upon completion, participants will be able to provide examples of how different disciplines approach patient autonomy and how this affects treatment planning and implementation.
• Describe how to identify stakeholders and their values in the rehabilitation process, and to understand the interpersonal dynamic among them.
• Upon completion, participants will be able to apply a stakeholder analysis tool to highlight the nuances of decision making in cognitive rehabilitation using a series of case studies.