Mary Jones is your 53-year-old patient with diabetes and obesity.These conditions developed after she began to take an atypicalantipsychotic drug for schizophrenia. Jones signed a treatmentcontract stating that she will keep all her medical appointments,attend diabetes education classes, and lose weight. She attendedone class but became paranoid and left halfway through it, andshe has gained 5 lb. You gave her educational materials to read,but you have discovered that she doesn't understand them. Shehas just missed her second consecutive appointment with you;last time, she didn't have bus fare. Neither her glycated hemoglobin. . . [Full Text of this Article]
Source Information
Dr. Bishop is an internist at Pennsylvania Hospital and a consultant with the Pennsylvania Health Law Project, Philadelphia. Dr. Brodkey is a clinical associate professor of psychiatry at the University of Pennsylvania School of Medicine and medical director of the behavioral health service of the Family Practice and Counseling Network, Philadelphia.
An interview with Dr. Bishop and Nancy Atkins, commissioner of the Bureau for Medical Services, West Virginia Department of Health and Human Resources, can be heard at www.nejm.org.
This article has been cited by other articles:
Buyx, A M
(2008). Personal responsibility for health as a rationing criterion: why we don't like it and why maybe we should. J. Med. Ethics
34: 871-874
[Abstract][Full Text]
Schmidt, H.
(2007). Patients' charters and health responsibilities. BMJ
335: 1187-1189
[Full Text]
Gostin, L. O.
(2007). Using Law to Facilitate Healthier Lifestyles--Reply. JAMA
297: 1982-1983
[Full Text]
Redman, B. K.
(2007). Accountability for patient self-management of chronic conditions; ethical analysis and a proposal. Chronic Illness
3: 88-95
[Abstract]
Iglehart, J. K.
(2007). Medicaid Revisited -- Skirmishes over a Vast Public Enterprise. NEJM
356: 734-740
[Full Text]
Previous
Interview
