Informed consent, bioethics, and patient value histories

Technologic advances, such as organ donation and the ability to sustain life when no hope for recovery exists, mandate a need to document each patient's value system during routine visits while the patient in fully competent. Clinicians who maintain patient value histories are better prepared to help families make crucial decisions during times when life-sustaining technologies are required. At a workshop sponsored by the Association of Physician Assistant Programs (APAP) in Cincinnati, ten health care professionals reviewed a program developed by the authors to help clinicians conduct ethical investigations into a patient's value system as part of routine history-taking, thus expanding the concept of informed consent.