Competing and conflicting interests in the care of critically ill patients

Medical professionals are expected to prioritize patient interests, and most patients trust physicians to act in their best interest. However, a single patient is never a physician’s sole concern. The competing interests of other patients, clinicians, family members, hospital administrators, regulat...

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Bibliographic Details
Published in:Intensive care medicine 2018-10, Vol.44 (10), p.1628-1637
Main Authors: Turnbull, Alison E., Sahetya, Sarina K., Biddison, E. Lee Daugherty, Hartog, Christiane S., Rubenfeld, Gordon D., Benoit, Dominique D., Guidet, Bertrand, Gerritsen, Rik T., Tonelli, Mark R., Curtis, J. Randall
Format: Article
Language:English
Subjects:
Anesthesiology
Conflict of Interest
Critical Care Medicine
Critical Illness
Emergency Medicine
Hospital patients
Human health and pathology
Humans
Intensive
Intensive care
Life Sciences
Medical colleges
Medical personnel
Medicine
Medicine & Public Health
Pain Medicine
Patient-centered care
Patients
Pediatrics
Physician-Patient Relations
Physicians
Pneumology/Respiratory System
Regulators
Research design
Review
Risk perception
Trust
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Summary:Medical professionals are expected to prioritize patient interests, and most patients trust physicians to act in their best interest. However, a single patient is never a physician’s sole concern. The competing interests of other patients, clinicians, family members, hospital administrators, regulators, insurers, and trainees are omnipresent. While prioritizing patient interests is always a struggle, it is especially challenging and important in the ICU setting where most patients lack the ability to advocate for themselves or seek alternative sources of care. This review explores factors that increase the risk, or the perception, that an ICU physician will reason, recommend, or act in a way that is not in their patient’s best interest and discusses steps that could help minimize the impact of these factors on patient care.
ISSN:0342-4642
1432-1238
DOI:10.1007/s00134-018-5326-2