eprintid: 18663 rev_number: 38 userid: 2171 dir: disk0/00/01/86/63 datestamp: 2015-05-07 13:34:38 lastmod: 2021-07-02 13:57:04 status_changed: 2015-05-07 13:34:38 type: thesis metadata_visibility: show contact_email: amandapaigeburns@gmail.com item_issues_id: duplicate_title_18656 item_issues_type: duplicate_title item_issues_description: Duplicate title to Burns, Amanda Paige (2013) Evidence, Influences, and Patient Autonomy: Utilizing the Ecological Model to Maximize Justice and Autonomous Choice in the Legal Doctrine of Informed Consent. Master Essay, University of Pittsburgh. item_issues_timestamp: 2013-05-03 06:18:21 item_issues_status: autoresolved item_issues_count: 0 eprint_status: archive creators_name: Burns, Amanda Paige contributors_type: committee_chair contributors_type: committee_member contributors_name: Bjerke, Elizabeth contributors_name: Meisel, Alan contributors_email: schmidte@pitt.edu contributors_email: meisel@pitt.edu contributors_id: SCHMIDTE contributors_id: MEISEL title: Evidence, influences, and patient autonomy: utilizing the ecological model to maximize justice and autonomous choice in the legal doctrine of informed consent ispublished: unpub divisions: sch_gsph_healthpolicymgt divisions: sch_law_law full_text_status: public abstract: This essay evaluates the current legal doctrine of informed consent and its ability to promote the rights of self-determination and autonomous choice. At the time that the doctrine was developed, American courts determined that the doctrine need not incorporate a requirement that a patient understand disclosed information, a determination largely based on the assumption that the vast majority of patients would be able to understand a reasonable disclosure. By analyzing the current body of research regarding patient health literacy, this paper seeks to establish that, contrary to the doctrine’s presumption of understanding, only a small minority of patients are capable of understanding and utilizing disclosed medical information in a way that allows them to make truly autonomous decisions. Furthermore, this paper will show that, in addition to failing to promote self-determination, the doctrine’s failure to require reasonable patient understanding results in tangible harm to the many patients who have limited health literacy, thus resulting in an unjust medical system that disadvantages a large group of patients, many of whom are already vulnerable to poor health outcomes due to other systemic and environmental influences. Recognizing these failures, this paper proposes that patient self-determination should be viewed as an individual behavior that is best promoted by a public health intervention that recognizes the complicated web of influences, of which informed consent law is but one, that effect a patient’s ability to understand medical information and make truly autonomous medical decisions. This paper will use the ecological model to identify these influences and suggest policy changes, including a revision of the legal doctrine of informed consent, that are most likely to promote patient autonomous choice in light of the complex web of influences that currently hinder patient autonomous choice. date: 2013-03-02 date_type: submitted publisher: University of Pittsburgh institution: University of Pittsburgh refereed: TRUE etd_access_restriction: immediate etd_patent_pending: FALSE thesis_type: masteressay degree: MPH citation: Burns, Amanda Paige (2013) Evidence, influences, and patient autonomy: utilizing the ecological model to maximize justice and autonomous choice in the legal doctrine of informed consent. Master Essay, University of Pittsburgh. document_url: http://d-scholarship-dev.library.pitt.edu/18663/1/Burns_MPHessay_4_2013.doc document_url: http://d-scholarship-dev.library.pitt.edu/18663/3/licence.txt