, Volume 25, Issue 3, pp 255-260
Date: 09 Jan 2010

Family Caregivers, Patients and Physicians: Ethical Guidance to Optimize Relationships

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Abstract

Family caregivers play a major role in maximizing the health and quality of life of more than 30 million individuals with acute and chronic illness. Patients depend on family caregivers for assistance with daily activities, managing complex care, navigating the health care system, and communicating with health care professionals. Physical, emotional and financial stress may increase caregiver vulnerability to injury and illness. Geographically distant family caregivers and health professionals in the role of family caregivers may suffer additional burdens. Physician recognition of the value of the caregiver role may contribute to a positive caregiving experience and decrease rates of patient hospitalization and institutionalization. However, physicians may face ethical challenges in partnering with patients and family caregivers while preserving the primacy of the patient-physician relationship. The American College of Physicians in conjunction with ten other professional societies offers ethical guidance to physicians in developing mutually supportive patient–physician–caregiver relationships.

This paper, written by Sheryl Mitnick, MPH, RN, Cathy Leffler, JD, and Virginia L. Hood, MBBS, MPH, FACP, was developed by the American College of Physicians (ACP) Ethics, Professionalism and Human Rights Committee. Members of the Committee were Virginia L. Hood, MBBS, MPH, FACP (Chair); Joseph J. Fins, MD, FACP (Vice Chair); Clarence H. Braddock, III, MD, MPH; Neil J. Farber, MD, FACP; Thomas H. Gallagher, MD, FACP; Richard A. Hranac, MD, FACP; Diane E. Meier, MD, FACP; Aliza Monroe-Wise, MSc; Alejandro Moreno, MD, FACP; Paul S. Mueller, MD, MPH, FACP; Richard L. Neubauer, MD, FACP; Shakaib U. Rehman, MBBS, FACP; Mahmoud Sharaf, MD; Mehdi C. Shelhamer, DO; Barbara J. Turner, MD, FACP; and Frederick E. Turton, MD, FACP. The paper was approved by the ACP Board of Regents on July 13, 2008. The paper has also been endorsed by the Society of General Internal Medicine, the American Academy of Neurology, the American Academy of Hospice and Palliative Medicine, the American College of Chest Physicians, the American College of Osteopathic Internists, the American Geriatrics Society, the American Medical Directors Association, the American Thoracic Society, the Society of Critical Care Medicine and The Endocrine Society.