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Medicine and Public Policy |

The Standard of Care: A Case Report and Ethical Analysis

JOHN LA PUMA, M.D.; DAVID L. SCHIEDERMAYER, M.D.; STEPHEN TOULMIN, Ph.D.; STEVEN H. MILES, M.D.; and JANE A. McATEE, J.D.
[+] Article and Author Information

▸Requests for reprints should be addressed to John La Puma, M.D.; Director, Section of Clinical Ethics, Lutheran General Hospital, 1775 Dempster Ave.; Park Ridge, IL 60068.


CHICAGO, ILLINOIS


© 1988 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1988;108(1):121-124. doi:10.7326/0003-4819-108-1-121
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Physicians increasingly allow their perceived legal responsibilities to displace their clinical judgment. Misunderstandings that surround the term "standard of care" have encouraged fears of liability and have led to the practice of defensive medicine. Physicians may consider the standard of care to be a technical or legal obligation, but an optimal standard would be one based on detailed knowledge of a patient's medical history and personal condition. It would include the physician's clinical judgment, which integrates specific technical and legal information with clinical experience in caring for patients. Occasionally, such judgment may conflict with the rulings of a court, which considers technical and legal information without the benefit of clinical judgment. Physicians must be prepared to be advocates for their patients, especially when legal proceedings are flawed or injurious. Systematic processes of examination and analysis, such as those used by ethics consultants, can help resolve questions about the standard of care.

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