Effective communication and ethical consent in decisions related to ICDs

Clark, Alexander M., Jaarsma, Tiny, Strachan, Patricia, Davidson, Patrician M., Jerke, Megan, Beattie, James M., Duncan, Amanda S., Ski, Chantal F. and Thompson, David R. (2011) Effective communication and ethical consent in decisions related to ICDs. Nature Reviews Cardiology, 8 12: 694-705. doi:10.1038/nrcardio.2011.101

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Author Clark, Alexander M.
Jaarsma, Tiny
Strachan, Patricia
Davidson, Patrician M.
Jerke, Megan
Beattie, James M.
Duncan, Amanda S.
Ski, Chantal F.
Thompson, David R.
Title Effective communication and ethical consent in decisions related to ICDs
Journal name Nature Reviews Cardiology   Check publisher's open access policy
ISSN 1759-5002
Publication date 2011-12
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1038/nrcardio.2011.101
Volume 8
Issue 12
Start page 694
End page 705
Total pages 12
Place of publication London, United Kingdom
Publisher Nature Publishing Group
Collection year 2012
Language eng
Abstract This Review examines recommendations and principles that promote good decision-making with regard to the insertion, deactivation, and potential malfunction of implantable cardioverter-defibrillators (ICDs). This guidance is important because ICDs are now used for primary and secondary prevention of arrhythmias in more than 20 diverse clinical populations, which accounts for the exponential increase in insertion rates over the past decade. Current guidelines require clinicians to provide personalized, culturally appropriate, and easy to understand information to patients on the benefits and harms of proposed treatment choices; however, obtaining valid informed consent for insertion and deactivation of ICDs is challenging. Initiating early conversations with patients and continuing this dialogue over time, implementation of localized care protocols, increased collaboration (particularly between cardiac and palliative care teams), and the provision of training for all health professionals involved in the care of these patients, can help to ensure that adequate informed consent is maintained throughout their care. In addition to providing information, health professionals should identify and address high levels of anxiety in patients and their next of kin and promote effective communication throughout decision making. In the future, use of standardized checklists or decision aids based on a clear understanding of the principles underlying key topics could support this process.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online 26 July 2011.

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2012 Collection
School of Nursing, Midwifery and Social Work Publications
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